The Tablet May/Jun 2016 by BC Pharmacy Association

Medical assistance in dying • Telemedicine clinics in pharmacies • Gutenberg and Wigston elected to Board

tablet

published by the British Columbia Pharmacy Association | www.bcpharmacy.ca | Volume 25. No. 3

MAY/JUN 2016

Compounding: A vital alternative for patients

40810576

A voice for community pharmacy

Pharmasave Pacific welcomes its new CEO, Greg Shepherd Our industry continues to change rapidly. Building on Pharmasave’s long history of success, Greg’s extensive experience and strong leadership in pharmacy provides Pharmasave the ongoing strength and distinctive focus to continue to drive the organization to new levels of success.

Pharmasave is the best choice for independent pharmacy in BC.  A strong pharmacy focused brand with 35 years of proven success  A true cooperative that is 100% member owned and governed  140 locations in BC, and over 550 coast to coast  Complete transparency, delivering all profits directly back to Members  Active in supporting the advancement of the pharmacy profession through advocacy and industry leading programs and professional services

With Pharmasave, own your own business, but never be on your own.

Pharmasave thanks Dave Reston, former CEO Pharmasave Pacific for over 3 decades of dedication and commitment to making Pharmasave the success it is today. Dave will continue to support Pharmasave in a Business Development role.

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MAY/JUN 2016 | VOLUME 25. NO. 3

contents Editor in Chief Angie Gaddy 604.269.2863, angie.gaddy@bcpharmacy.ca Senior Editor Matilda Meyers 604.269.2866, matilda.meyers@bcpharmacy.ca 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.

14 Medical assistance in dying

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

18 C ompounding: A vital alternative for patients

Publication agreement #40810576

On the cover: Sarah Redding, a pharmacist at the Victoria Compounding Pharmacy, prepares a specialized compounded medication for a patient.

22 Telemedicine clinics open in pharmacies

Features

Columns

Regulars

edical Assistance in Dying M BC pharmacists voice concerns about legislation

6 President’s Message

eet Kevin Davies M Author of The $1,000 Genome and Cracking the Code

On the Cover:

7 CEO’s Message

PIC D Post-traumatic stress disorder: Understanding its symptoms and treatment options

areer Listings C Find a job in pharmacy

Compounding: A Vital Alternative for Patients Bustling Victoria pharmacy supplies compounds across BC

elemedicine T Clinics in pharmacies help alleviate physician shortage

24 Board Elections Linda Gutenberg and Jamie Wigston elected

Phase 2 of genome project expands research across country Building relationships essential to business success

8 Member Services Maximize the value of your membership

dvocacy A Pharmacists play key role in maximizing quality care for seniors

13 Pharmacy Practice Support Working group addresses member concerns with MAID

26 Annual Conference Author Kevin Davies to kick off event

30 Student Speaker Series

A voice for community pharmacy

Mark Kunzli shares genome project insights

Got a suggestion for an article in The Tablet? Email info@bcpharmacy.ca with your story ideas.

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May/Jun 2016

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SMALL TALK

In the news A reminder that pharmacists do a lot #MoreThanPills

Proposed College bylaw amendments for comment

March was Pharmacist Awareness Month (PAM) in Canada. During the month the BCPhA ran its campaign "More Than Pills” to highlight the services that pharmacists deliver beyond dispensing.

Recently, following stakeholder engagement done earlier this year, the College of Pharmacists of BC posted draft bylaw amendments for comment. These amendments were approved by the College Board at its April 14 meeting.

We profiled several pharmacists and pharmacies doing important work around BC, including: • Regan Ready: A pharmacist providing critical care for patients in remote areas via telepharmacy. • People’s Drug Mart in Port McNeill: This pharmacy on the northern part of Vancouver Island has unique, collaborative working relationships with local health-care professionals in the rural community. Improved patient care is just one of the many benefits. • Ellen Bovair: A pharmacist who is demonstrating that pharmacymanaged warfarin is safe, quick and convenient for patients. To read more about these pharmacists and watch Ready’s video visit www. bcpharmacy.ca/your-pharmacist. Remember, you can always read about the great work pharmacists are doing around the province throughout the year in The Tablet. Follow us on Twitter @bc_pharmacy and retweet stories throughout the year using the hashtag #MoreThanPills to continue spreading the message.

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May/Jun 2016

The draft amendments relate to changed definitions, responsibility of pharmacy managers, owners and directors, pharmacy security measures and minor housekeeping, the College states. Pharmacists and the general public have until July 16, 2016, to submit their comments on these proposed amendments. As a help to members, the BCPhA is currently reviewing these draft amendments with legal counsel and will publish our analysis for members in mid-June so they may determine what comments they would like to make prior to the July 16 deadline. The Association will ask for members’ feedback after sharing our review, and we will incorporate your thoughts into our final submission to the College and Ministry of Health. For members who would like to undertake this review on their own, they should read both the amended bylaws and the revised Professional Practice Policy PPP-74: Community Pharmacy Security. PPP-74 expands upon the obligations mentioned in the bylaws

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and provides additional context. The draft bylaws have been posted on the College website at www.bcpharmacists.org/bylawscomment with changes tracked to illustrate the amendments. The BCPhA provided its feedback to the initial draft in January 2016 during the stakeholder consultation process. It is important to note that these new obligations impact pharmacy managers who are employees as well as director-employees and pharmacy owners. We encourage members to make their own submissions to the College or Ministry of Health by following the steps listed on the College’s website. If you have any questions, contact chief operating officer, Cyril Lopez via email at cyril.lopez@bcpharmacy.ca or phone 604-269-2869.

MEET KEVIN DAVIES

Meet...Kevin Davies Author of The $1,000 Genome and Cracking the Code With more than 25 years’ experience in science communication, Davies is currently vice president of business development in the publications division of the American Chemical Society (ACS), the largest scientific society in the world. He has special responsibility for the society’s open access programs and was instrumental in the launch of ACS Central Science, the ACS’ first fully open access journal, in March 2015. He also serves as publisher of C&EN (Chemical & Engineering News), the ACS’ weekly news and science magazine.

Kevin Davies is a British author, editor and publisher who specializes in medical genetics, personalized medicine and the Human Genome Project. He will kick off the BCPhA’s 2016 Annual Conference, “The DNA of Pharmacy,” as the keynote speaker on Friday, May 27. Davies is the author of three popular science books, most recently The $1,000 Genome (Simon & Schuster, 2010), an exploration of the revolution in DNA sequencing and personal genomics. His 2001 book Cracking the Genome was translated into 15 languages. Davies’ first book, Breakthrough (co-authored with Michael White), examined the race for the BRCA1 breast cancer gene and Davies served as technical consultant on the 2012 film Decoding Annie Parker. He was also invited by Jim Watson to co-author the second edition of DNA: The Secret of Life. Davies joined the editorial staff of Nature in 1990 and in 1992 was the founding editor of Nature Genetics, the world’s leading genetics research journal. He also worked as a science editor at the Howard Hughes Medical Institute, was the editor-in-chief of Cell Press from 2000-2001 and the launch editor for Bio-IT World, a trade magazine covering big data in the life sciences, in 2002.

Davies holds an M.A. in biochemistry from Oxford University and a Ph.D. in molecular genetics from the University of London, where he worked on the mapping of the cystic fibrosis gene at St Mary’s Hospital Medical School. He also held postdoctoral fellowships at MIT and Harvard Medical School. What is the quality you most admire in a person? A sense of humour. What do you consider your greatest achievement? Launching Nature Genetics was “my baby.” Also singing on stage in Carmen at Covent Garden when I was 12! What words or phrases do you overuse? I get nervous when I start sounding like an American. Which talent would you most like to have? Perfect pitch – like my dad. What is your idea of perfect happiness?

End in the ‘60s (musical director of Fiddler, Cabaret, etc.) If you could change one thing about yourself, what would it be? A little more hair and/or be a better guitarist. What is it that you most dislike? Arrogance. What is the most common misconception about the use of genomics for health care? That it will cure cancer. What was the most surprising thing you discovered when you had your DNA sequenced? I carry the gene for hemochromatosis – ironically I published the paper describing the discovery of the gene 20 years ago! What should pharmacists examine when considering the use of pharmacogenomics in the delivery of health care? We have to make use of this information to better tailor drug dosage to individual patients, but do so in an accurate and reliable fashion. What do you see on the horizon in five to 10 years in using genomics for health care delivery? I’m struck by the rapid uptake of exome and genome sequencing in medical centres in the past few years. I would love to see this embraced widely. What do patients want in sequencing their DNA? Everyone is different, but reassurance is the first thing that strikes me.

An email-free day. What is your most treasured possession? A scrapbook of my dad’s press clippings covering his musical career in the West

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ALLISON NOURSE | PRESIDENT

Phase 2 of genome project expands research across country Pharmacy has had excellent media attention this year on positive pharmacy stories. Most of these stories have been about the BCPhA’s pharmacogenomics project, “Genomics for Precision Drug Therapy in the Community Pharmacy,” which examines the potential for community pharmacies to provide DNA-specific medication advice in order to optimize drug therapy outcomes for patients. Personalized medicine has become a hot topic, highlighting the good work pharmacists can do and the crucial role they play in the healthcare system. We need to leverage this positive energy and continue to focus on improved patient outcomes. We have the technology to enhance drug safety for patients and we need to use it. Pharmacogenomics has wide-reaching clinical use, from preventing adverse drug reactions to predicting response rates of certain medications. A simple saliva test can allow pharmacists to determine if a newly prescribed medication could cause harm or be ineffective for a particular patient, therefore allowing for appropriate changes before the medication is even started. Drug therapy problems that were previously unknown until a patient took a medication will soon be easily prevented, minimizing the time taken to reach optimal drug therapy outcomes. There is still plenty of research, however, to be completed on pharmacogenomics. While certain genetic variants may increase the possibility of having an adverse drug reaction, it does not mean the patient will experience the reaction, and vice versa. That being said, if I knew there was the possibility that a drug could give me a severe reaction and there were other drugs available, I would opt for the medication that did not show the same potential for the adverse reaction. I would prefer to know that I was getting the best drug and the right dose for me the first time I tried any treatment. Exciting times are still ahead of us as BCPhA prepares for the start of Phase 2 of the genome project in late 2016. Discussions with partners are underway to support the project budget of $2 million, allowing for further research to be conducted across Canada. BCPhA

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May/Jun 2016

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has developed a registration form on www.bcpharmacy.ca/genome for patients, health-care professionals and other investors to express interest in participating in the project. We estimate that Phase 2 will take 18 months to complete and involve 1,000 patients across Canada. It will assess participants’ exomes for 160 gene drug variants to find out if these variants are clinically actionable. This phase is a necessary step that will help us determine whether this particular pharmacogenomic service is commercially viable. It will also quantify market opportunity and assess the financial impact on drug coverage costs under private benefits. The project will test the specific medications that each participating patient is currently prescribed to determine efficacy and dosage. Patients, their prescribers and pharmacists will be given the actionable results from these tests. A common database will be identified to house patient information for individual drug queries. An important element of the project will also be to develop standard operating procedures for prescriber and patient communication. Finally, it will assess the potential profitability of offering the service by community pharmacies. Pharmacists have an opportunity to use powerful medication knowledge to provide personalized care to patients. An opportunity like this should not be missed. The pharmacy profession cannot afford to wait and see what happens with pharmacogenomics. We need to jump on this and learn as much as we can as soon as possible. In a few years, pharmacogenomics will provide a baseline for patient care; it will be a requirement, not an option. We’ll be talking about the importance of pharmacogenomics and our project at the BCPhA Annual Conference in Kelowna. The conference is appropriately titled “The DNA of Pharmacy.” We’ve brought in world-renowned speaker Kevin Davies, author of The $1,000 Genome. I encourage each of you to attend this year’s conference to get up-to-speed on advances in genomics and the role pharmacists can play.

GERALDINE VANCE | CEO

Building relationships essential to business success The former CEO at the BCMA (now known as the Doctors of BC) had a great saying: “You can make war any day, but you can’t always make peace.” Dr. Mark Schonfeld was an expert at building relationships and keeping them strong. Since taking this job, I think about Mark often and how he approached tough situations. No one would ever accuse doctors of being pushovers. But during the nearly 11 years I was at the BCMA, the organization stood its ground on the issues that mattered to its members, while recognizing the importance of understanding and often meeting the needs of the other side, too. Barely a day has gone by since I joined the BCPhA when there wasn’t someone nipping at pharmacists’ heels. Community pharmacy has been challenged by so many different issues: Commodity drug prices, third-party payers changing needs and requirements, efforts by the College of Pharmacists of BC to get more directly involved in the day-to-day operations of pharmacy, provincial legislative changes governing pharmacy operations and the reputational hits related to methadone. And, we are now about to deal head-on with medical marijuana, assisted dying and what national pharmacare actually means.

tough battles along the way. And thanks to the many members who are MLA contacts, we have been able to put a face to our profession in BC and make our case on some pretty important issues. We have built some bridges and demonstrated we can be counted on to stand up for what is right and show that we are not apologists for bad behavior. Changes to the Pharmacy Operations and Drug Scheduling Act (PODSA) will be followed by a whole set of new College bylaws needed to support the Act. We have been happy to lend our support to the health minister and his team, first on the

“We have had to do some hard work to raise the profile of the profession..."

That’s a great many issues and a lot of people attached to various aspects of those issues. When I arrived at the Association, the profession of community pharmacy had a pretty low profile. People liked their pharmacists, but it’s fair to say no one thought pharmacists were political powerhouses like doctors or nurses. Our members were mostly seen as the nice people behind the counter who you got your pills from. Supportive and smart but no force to be reckoned with, that’s for sure. We have had to do some hard work to raise the profile of the profession and demonstrate that our voice needs to be heard on key issues that affect community pharmacists. We’ve fought some

PharmaCare Provider Agreement process and more recently on the objectives they set when making revisions to PODSA. Giving the government and the College the information it needs to ensure pharmacy owners operate in a way that meets the public need makes sense. I believe our work in building a better relationship with government means that we are believed when we say we want the few bad apples out of the barrel. And I trust that as the bylaws move forward and we keep a close and critical eye on what’s being proposed it will be understood we do that in support of keeping community pharmacy a viable participant in our health-care system. The task of building strong relationships is never over. Needs change, players change, but adopting a perspective of trying to understand the other person’s mandate and aspirations always makes sense. As another former boss of mine was often heard to say: “If you look after the relationship, the business takes care of itself.”

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May/Jun 2016

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CYRIL LOPEZ | CHIEF OPERATING OFFICER

Maximize the value of your membership Spring is here and as we come out of what feels like winter hibernation, the new season offers a chance to take a fresh look at everything. Here I’d like to share a few ways in which to maximize the benefits of your BCPhA membership this year.

Pharmacists: • Financial literacy for couples • Executor and beneficiary education • Retirement income and wills/estate planning

Our Pharmassist service provides you with access to brief solution-focused counselling to address any issues that may be impacting your wellbeing and/or ability to perform your professional responsibilities. The fully confidential service also provides advice on a wide range of employment-related issues, such as your rights and duties in the workplace, a work-related conflict or a specific grievance, and can be a crucial first step towards resolution. Members can also access counselling sessions in the aftermath of a critical incident or work-related traumatic event, such as a robbery, assault or personal threats.

Business owners: • Entrepreneurship 101 program • Incorporating a pharmacy from a legal and tax perspective • Tax reduction, business valuation and succession planning

The Wealth Management Referral Service gives members the opportunity to have a complimentary consultation at RBC Dominion Securities with an investment advisor who has a specialized understanding of the pharmacy business. This can benefit pharmacy owners on topics such as reducing taxes, succession planning, financial planning, estate planning, capital gains exemption and much more. Staff pharmacists can benefit through personal financial assessments, covering topics such as investment portfolios, financial planning and estate planning.

As a member, you also receive regular access to CPhA resources, including a complimentary annual subscription to the Canadian Pharmacists Journal (with The Tablet), a complimentary subscription to CPhA’s Therapeutic Highlights CE (a weekly email service) and complimentary access to RxTx (provided by the College of Pharmacists of BC). You are also eligible for discounted rates on continuing professional development programs such as CPhA’s Lab Tests program, QUIT smoking cessation and ADAPT as well as a discounted rate to the Canadian Pharmacists Conference. And finally, for this time of the year, we offer you our Annual Conference where we bring you expert speakers on a wide range of topics helpful to your career. The learning and CE credits that come with it are in addition to the social connections you can make with other pharmacists and stakeholders. Treat yourself this May – take time just for yourself to learn, connect and enjoy the warm sun of this year’s Okanagan location. See more details on our conference in this issue of The Tablet on pages 26 - 29. To learn more and register, visit www.bcpharmacy.ca/conference.

As a complement to the wealth management consultation, we offer Financial Literacy@BCPhA where the Financial Literacy Counsel provides integrated and non-biased financial, legal and tax advice to Canadian health-care professionals. Their team ofprogroup_ad_v3.ai financial counselors, accountants and legal advisors help you make wiser decisions about money without the pressure of buying financial products. Their services are customized to our members’ needs and cover:

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CHERIE PAYNE | ADVOCACY

Pharmacists play key role in maximizing quality care for seniors Provinces with more seniors should get more federal health dollars. That was the message from BC Health Minister Terry Lake to reporters this spring. Over-medication, a growing need for supports to help older British Columbians age in place (a term used to describe a person living in their home for as long as possible), off-label prescribing of dementia medicines and antipsychotics to those living in residential care and continued growth in health costs all make providing health care to elderly BC residents a timely concern. The most vulnerable members of BC’s senior communities are also those most likely to come into regular contact with pharmacists. Community pharmacists take a multitude of questions from these patients. They face issues transitioning from acute to community care and need advice on best medication options for low incomes as well as how to manage multiple medications. Many questions come from family members of elders living in long-term residential care homes. Pharmacists are front line sources of advice for older patients, and as a result play a key role in helping older British Columbians improve their quality of life. Adapting prescriptions, monitoring for adverse medication interactions and identifying solutions to poor reactions through compounding are becoming increasingly important for comprehensive patient care. Questions around which medications can be delivered in alternative ways – or where crushing, splitting, rectal or other applications may or may not be appropriate – are directly within the purview of pharmacists, who may be more knowledgeable about the medication in question than other members of the patient’s health-care team. From clinical expertise to maximising public dollars Many BC residents find themselves juggling roles: Caregiver to an aging parent, parent to their children, meeting the demands of employers, employees and contributing as taxpayers and good neighbours. This is the same population seeking affordable family housing, reliable jobs, a living wage and access to childcare. They

are squeezed — sandwiched between supporting children while also providing regular care for older loved ones. Government decision-makers face a similar squeeze. Paul Kershaw is a UBC professor, public speaker, regular media contributor and founder of the Generation Squeeze campaign. He estimates that Canadian governments currently combine to spend between $33,321 and $40,152 per citizen age 65+. This is mostly on medical care, the Canada Pension Plan (and Quebec Pension Plan), Old Age Security and other retirement income subsidies. By contrast, Kershaw says annual spending per person under age 45 for grade school, post-secondary, medical care, childcare, parental leave, family tax breaks, Employment Insurance, Workers’ Compensation programs, tax breaks for housing and more all add up to less than $12,000. The proportion of Canadians over age 64 will rise from 15 per cent of the national population to 23 per cent over the next 18 years. As the population ages, public spending will balloon. In BC, 40 per cent of the provincial budget is currently spent on health care; the financial implications are clear. Community pharmacists are a valuable piece of the puzzle needed to help government meet these challenges head on. Pharmacists already support appropriate monitoring of medicine use through data collected on PharmaNet. Encouraging other prescribers to make use of this service helps ensure an accurate picture of the medication combinations and off-label prescriptions that BC seniors encounter. Identifying age-appropriate vaccines for ailments such as the flu and shingles helps the province prevent hospital stays and long-term illness. Helping seniors remain active and independent so they can continue to participate in community life is a shared goal. Increased funding from the federal government, strong support for community care and aging in place and broadening the scope of practice of primary health-care team members are important steps towards ensuring quality care and maximum impact of public dollars for seniors care.

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May/Jun 2016

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DRUG AND POISON INFORMATION CENTRE

Post-traumatic stress disorder: Understanding its symptoms and treatment options By Raymond Li, B.Sc. (Pharm.), M.Sc. Reviewed by C. Laird Birmingham, MD, M.H.Sc., FRCPC Emotional and physiological effects experienced by most people following a traumatic event are regarded as “normal responses to an abnormal situation.” Most people are resilient and recover, but some do not and may be diagnosed with post-traumatic stress disorder (PTSD). While drug therapy plays a role in PTSD, it’s important to discuss non-drug therapies and some of the challenges with PTSD in patients from other cultural backgrounds.

preference. The strongest evidence is for SSRIs (paroxetine, sertraline and fluoxetine) and venlafaxine, with response rates up to 60% and remission rates up to 30%. There is some evidence that remission rates are higher with longer treatment (>12 weeks), and that relapse rates are higher when effective drug therapy is stopped early (after six months); some recommend drug therapy should be continued for 12 months or more.

PTSD can cause social and occupational impairment and reduce quality of life. It is characterised by four symptom clusters (see Box 1) lasting for more than one month. PTSD is also associated with high rates of somatic complaints such as pain or dizziness and comorbid psychiatric disorders (depression, anxiety and substance use disorders). The lifetime prevalence of PTSD in Canada is estimated at about 9% with a one-month prevalence of 2.4%. The prevalence is higher in refugees (>20%), survivors of rape (up to 50%), and survivors of torture (63-96%).

There are also second-line and third-line recommendations for PTSD, and adjunctive treatments like prazosin for nightmares (consult practice guidelines for more information). Patients may ask about methylenedioxymethamphetamine (MDMA) and cannabinoids. Although reported to be helpful in PTSD, their use outside of carefully controlled studies cannot be recommended.

Common causes include combat trauma, sexual assault, childhood abuse and neglect or threat with a weapon. Terrorism, vehicle accidents, fire, natural disasters, life-threatening medical diagnoses and the sudden unexpected death of a close relative or friend can also cause PTSD. It is unclear why PTSD occurs. Some risk factors include: Younger age, psychiatric history, lower socioeconomic and education level, and other post-trauma stressors. Conversely, good social support after trauma has been shown to be protective. Treatment options. The goals of treatment include eliminating or reducing PTSD symptoms and disability and reducing relapse. Treatment of comorbid psychiatric conditions increases the chance of treatment success. Psychotherapy. Psychotherapy (see Box 2) is usually regarded as first-line treatment for PTSD. With the most effective therapies, numbers needed to treat for remission of PTSD range from two to four patients. Benefits can be long lasting. However, psychotherapy may not be accessible and is not accepted by certain cultures. Pharmacotherapy. Drug therapy should be offered when psychotherapy is not available or when patients express a

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Box 1: PTSD signs, symptoms and assessment Intrusion: E.g. recurrent, distressing memories or dreams and flashbacks. Avoidance: Of thoughts, people and places associated with the trauma. Numbing or negative cognition and mood: E.g. amnesia, persistent and exaggerated negative beliefs about oneself or the world, fear and anger, diminished interests, detachment from others, inability to experience happiness or satisfaction. Arousal: E.g. irritability and aggression, reckless or selfdestructive behaviour, hypervigilance, concentration problems and sleep disturbance. The Clinician Administered PTSD Scale (CAPS) is one of the most used assessment tools and rates the intensity and frequency of symptoms. Past studies have shown a change in CAPS scores of 15 or more were deemed clinically significant (total CAPS score 0-136; 20-39 = mild PTSD; 40-59 = moderate; 60-79 = severe; 80 or more = extreme.)

PTSD symptoms in non-Western cultures. Studies have shown that some PTSD symptoms are universal across cultures. However, the symptoms and rates of PTSD vary by age and ethnicity. Some cultures may find events such as destruction of religious symbols more distressing than physical trauma. Factors like the inability to perform funerary rights for family members and the stress that refugees face can increase PTSD risk. There is limited data on psychotherapy and extremely limited data on pharmacotherapy for PTSD in the refugee population in general, and almost no data on their use in refugees from Middle Eastern cultures.

Box 2: Some psychological interventions for PTSD Trauma-focused cognitive-behavioural therapy (TF-CBT) encourages patients to engage with and explore traumatic material in depth, gaining control over traumatic memories. Components include exposure to the traumatic memory through mental imagery or revisiting the actual scene or similar events, cognitive restructuring, various coping skills training and education about PTSD. By opening up the traumatic memories and adding new information in a safe environment, the aim is to extinguish the learned fear response to the traumatic stimuli. Prolonged exposure CBT has the strongest evidence for benefit.

Tips for pharmacists • Consider PTSD and referral in patients with unexplained somatic symptoms, reckless behaviour, joylessness, introversion, “spacing out,” hyperarousal and in patients with depression, anxiety or substance abuse, especially after disclosure of a traumatic event. • Acknowledge pain and suffering; help remove feelings of shame or weakness and stigma around PTSD. • Provide support and reassurance that symptoms can improve. • Patient education and understanding are important for treatment perseverance and adherence – help patients understand why they are receiving therapy but be sensitive to the patient’s comfort level.

With Eye Movement Desensitization and Reprocessing (EMDR), patients imagine the traumatic memory while simultaneously articulating a positive reframing of the event and performing bilateral eye movements of other actions. This can reduce the emotional impact of the traumatic memory. Narrative Exposure Therapy (NET) has patients develop a narrative of their lives, focusing on traumatic events. Similar to TF-CBT, it allows patients to relive traumatic events in a safe environment, and by placing the traumas in the context of their entire lives (with a focus on “in the past”), the hope is that meaning can be made from chaos. NET was developed to meet the needs of non-Western cultures. Psychological therapies typically require eight to 12 weekly sessions, each lasting one to two hours.

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DEREK DESROSIERS | DIRECTOR, PHARMACY PRACTICE SUPPORT

Working group addresses member concerns about medical assistance in dying legislation

It has been more than a year since the Supreme Court of Canada’s original ruling in Carter v. Canada that would allow Canadians to access medical assistance in dying (MAID). The current June 6, 2016 deadline for the federal government to develop legislation to support the court’s ruling is fast approaching. Regardless of your stance on the issue it is clear that MAID will become part of the health-care landscape in Canada and it is essential that we be part of the discussion.

In addition, to help inform our members on the practical issues of physician-assisted dying, we reached out to Dr. Ellen Wiebe, a Vancouver family physician who enabled a patient to access physician-assisted death following a court approval. On March 10, BCPhA hosted a live webinar with Dr. Wiebe,

“Regardless of your stance on the issue it is clear that MAID will become part of the health-care landscape in Canada and it is essential that we be part of the discussion."

It is assumed that provincial governments and health-care regulators will also be required to draft legislation to determine how MAID will operate in their respective regions. The BCPhA has formed a working group to ensure our members’ concerns are heard in the drafting of that legislation. The working group will build upon the recommendations made by the BCPhA Board in its position statement on assisted-dying released in February. In it we state that pharmacists should be both consulted and protected in the drafting of the legal framework to allow access to dying with the assistance of a physician (and associated health practitioner care teams). We also state that: • P harmacists and pharmacy technicians should be protected under the law if dispensing medications at a prescribers’ request that may be used to end the life of a patient who has requested assistance with dying; • Pharmacists and pharmacy technicians should have the legal right to decline to dispense life-ending medications on the grounds of personal conscience, religion or belief.

who provided information on the assisted dying process and medications commonly used, followed by a lengthy question and answer session. This webinar is available to members on the BCPhA website. This session highlighted the fact that there remain a number of unanswered questions about the rules that will govern the dispensing of medications for assisted dying and how they would balance access to care, existing regulations and the responsibilities of pharmacists. What medications can be used in BC? Are there additional prescription requirements? What are the responsibilities of a conscientious objector? These are all questions that must be answered. As the federal and provincial legislation continues to be developed, BCPhA wants to ensure the concerns and questions from our members are addressed. As the group’s work is now underway, we will continue to keep members updated on this issue as it unfolds. To read more on the subject of assisted-dying, see the feature article on pages 14 - 17.

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May/Jun 2016

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MEDICAL ASSISTANCE IN DYING

BC pharmacists offer advice on assisted-dying legislation New BCPhA working group will make recommendations to government on pharmacist involvement in new laws

By Angie Gaddy As the health professionals who could be dispensing medications to end a patient’s life, BC pharmacists are stepping up to ensure their voices are heard in Canada’s debate on medical assistance in dying (MAID).

In February 2015, the Supreme Court of Canada declared the law against physicianassisted death invalid and gave the federal government a one-year time frame to draft legislation. In January 2016, the Court then gave the government a four-month extension to draft the new legislation. The federal government announced its proposed legislation on April 14, 2016, which will be debated and then passed by the House of Commons. Pharmacist associations across the country have provided input and appeared before parliament to offer advice. The bill must be finalized by June 6, 2016.

Vancouver family physician Dr. Ellen Wiebe assisted a woman suffering from ALS in ending her life in late February 2016. Wiebe spoke at a March webinar on assisted-dying for BCPhA members.

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While the governments continue to grapple with the legislative framework, the BC Pharmacy Association created a working group of members this spring to address issues community pharmacists will face when assisted-dying legislation comes into effect in June. The group’s final recommendations will be given to lawmakers to help them draft language that protects patients and pharmacists.

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“It’s important that pharmacists are in the driver’s seat when it comes to addressing the very real issue of dispensing a medication that is intended to end someone’s life,” says Geraldine Vance, BCPhA CEO. “No one else will know such intricate and important details as pharmacists, especially community pharmacists. Many of these patients will want to die at home, and that means community pharmacists will be receiving these prescriptions.” The group is tackling such issues as ensuring protection under the law, allowing pharmacists the ability to refuse participation, prescription requirements, communications with physicians and coverage under PharmaCare. The final recommendations will be given to key provincial stakeholders to help influence their decisions. Since health care is delivered at a provincial and territorial level, it will be up to the provinces to determine how exactly healthcare professionals will deliver and participate – or not – in assisting a patient in their death. At the same time it approved the fourmonth extension, the Supreme Court also

allowed patients the ability to seek a court exemption to end their life with the help of a physician during the interim period. In late February, Vancouver family physician Dr. Ellen Wiebe assisted a woman suffering from ALS in ending her life. The case brought to light complexities in legal interpretation, when a BC pharmacist had to withdraw in providing the medications at the last minute. The pharmacist was advised the College of Pharmacists of British Columbia would not support them, even though Alberta Court of Queen's Bench Justice Sheilah Martin specifically exempted pharmacists from criminal prosecution and the ruling should apply across Canada. “I didn’t blame them from withdrawing,” says Wiebe, who spoke at a March webinar on assisted-dying for BCPhA members. “We were supported by our College. The College of Physicians and Surgeons was very clear if we had a court decision, we were fine and they had written guidelines for us to follow,

but the pharmacists did not.” Wiebe obtained the medications on her own, and assisted the patient in dying. She later took the case to the media, expressing concern about the College of Pharmacist’s direction to its registrants. Four days after the patient’s death on February 29, the College updated its website saying a pharmacist must be authorized by a court order to dispense drugs as part of the assisted dying process. For many, the choice of medications in medical assistance in dying is still confusing. Both oral medications and drugs administered intravenously will be legal under the new framework. Quebec’s assisted-dying laws only allows for IV administration. Wiebe says it’s important for patients to have a choice between oral medications and IV. But what may determine whether a patient chooses intravenous or oral medications

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is simply access. Oral medications – secobarbital and pentobarbital – used by patients in Oregon (the first U.S. state to adopt assisted-dying laws) are not available in Canada. Secobarbital, which was developed in the 1930s as a sleeping pill, has been used for short-term insomnia, epilepsy and pre-operative anesthesia. U.S. patients can face a different access barrier: Price. Since Valeant Pharmaceuticals purchased secobarbital, or Seconal, the company doubled the price to US $3,000 for 100 capsules. Prior to that, the drug had been selling for US $1,500 for 100 capsules. The price had been climbing since 2009, when the same amount of capsules sold for less than US $200. Pentobarbital can cost about $23,000 a dose and is becoming difficult to get in the U.S., where it was being used by prisons for lethal injection. In 2005, the European Union banned the export of goods for use in capital punishment or

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MEDICAL ASSISTANCE IN DYING

Key milestones of medical assistance in dying in Canada 1972 – The federal government decriminalizes attempted suicide. 1970s – A number of court cases affirmed that a mentally competent person could have the right to refuse medical intervention.

September 1993 – The Supreme Court of Canada upholds the laws against physician-assisted death in a case by a BC woman.

2005 – A Quebec MP introduces a right-to-die bill in the House of Commons. The bill does not pass. She tries again in 2009 but it also fails.

Jan. 15, 2010 – A BC woman suffering from the terminal condition spinal stenosis ends her life through physician-assisted suicide in Switzerland. Her daughter later becomes a plaintiff in the court case Carter v. Canada.

April 2011 – The BC Civil Liberties Association files a lawsuit challenging Canadian laws prohibiting physician-assisted dying.

June 2012 – The BC Supreme Court rules that Canada’s laws against physician-assisted dying are unconstitutional because they discriminate against the physically disabled.

October 2013 – The BC Court of Appeal overturns the BC Supreme Court ruling of 2012.

June 2014 – Quebec passes Bill 52, which allows terminally ill patients medical assistance in dying, which will go into effect in December 2015.

August 2014 – The Canadian Medical Association altered its longestablished opposition to doctors assisting in suicides.

January 2015 – A patient from Quebec City becomes Canada’s first patient to die legally with the aid of a doctor.

Feb. 6, 2015 – The Supreme Court of Canada unanimously strikes down Criminal Code that prohibits physician-assisted suicide, giving the federal government a year to draft new laws.

Jan. 15, 2016 – The Supreme Court gives the federal government a four-month extension to draft new legislation around assisted dying. In the interim, patients seeking help from a doctor to hasten their death can apply for a ruling from a superior court in their home province.

April 14, 2016 – The federal government introduces proposed legislation. See breakout box on page 17 for more details.

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Dr. Heidi Oetter, registrar for the College of Physicians and Surgeons of BC, says physicians can't carry out assisteddying alone. “It needs the help of others in the health-care team, of which pharmacists are a part of," says Oetter.

torture. Six years later, Denmark-based Lundbeck Inc., announced it would restrict the distribution of pentobarbital and purchasers had to attest it would not be used in capital punishment. Since Canadians don’t have access to secobarbital or pentobarbital, Wiebe says patients taking oral medications would have to use narcotics and sedatives, but for patients who are already on opioids for pain it may not work. Other options include combinations of lorazepam, diazepam and chloroquine sulphate or chloroquine phosphate. Antiemetics are required in advance to ensure the patient doesn’t vomit or become nauseated. And for patients who can’t swallow quickly or have issues with vomiting, choking or bowel obstruction, oral medications wouldn’t be the right choice. In Quebec, which based its IV medication requirements on protocols from the Netherlands, physicians use a combination

of three medications: First, a sedative to induce sleep (Midazolam, 10 mg) within one to two minutes, a second sedative to induce a coma with no reflexes (Propofol, 1,000 mg) after the patient has gone to sleep, and a third medication, a neuromuscular blocker (Rocuronium, 200 mg), which is given after the patient is comatose. This third medication is not for the patient, but for the family members attending the death. This is so they won’t see any signs of gasping or the death rattle, says Wiebe. The patient’s heart stops in about five minutes.

Federal government legislation In its proposed legislation announced

Whether it be for oral or IV medications, other jurisdictions say that patients must have two complete sets of drugs.

on April 14, the federal government

“The reason for this is once you’re there you want everything to go smoothly,” says Wiebe.

seek or receive medical assistance in

On February 26, the federal government joint committee on assisted dying released its report in which it gave substantive safeguards including ensuring the patient had a “grievous and irremediable” medical condition with “enduring suffering that is intolerable.” The report also recognized other health-care professionals are involved in the process of assisted dying.

mental illness from seeking medical

“Physicians can’t do this alone,” says Dr. Heidi Oetter, registrar for the College of Physicians and Surgeons of British Columbia. “It needs the help of others in the health-care team, of which pharmacists are a part of.”

and must be in an “advanced state

will not allow anyone under 18 to dying. It also precludes someone with help to die. The proposed legislation states that anyone seeking assisteddying must have a serious and incurable illness, disease or disability of irreversible decline in capability” with their death “reasonably foreseeable.” The federal government also cut off the ability for “suicide tourism,” limiting assisted-dying only to those whose health care is paid for by Canada. The legislation protects not

Medical assistance in dying in the U.S. and Europe Oregon’s Death with Dignity Act, on which other states have based their legislation, includes several requirements that relate to pharmacists: • For prescriptions dispensed at a pharmacy, the physician must notify the pharmacist in advance and deliver the written prescription in person or by mail. • Medication counselling should be provided to the patient whenever practical. • Health-care practitioners, including pharmacists, have the right to choose to participate or not. • A pharmacist who chooses not to participate should inform the physician and may refer to a willing pharmacy or pharmacist, but is under no requirement to make a referral. • Within 10 calendar days of dispensing a lethal medication dose, a pharmacy must complete and submit a dispensing record. In Europe, Luxembourg, Belgium and Switzerland have laws allowing for assisted dying. In Switzerland, where assisted suicide has been legal since the 1940s, patients must participate in administering the lethal dose of medication. And unlike other jurisdictions, patients don’t necessarily have to be a resident of Switzerland. That’s led to what some call “suicide tourism.” In the Netherlands, euthanasia has been decriminalized since 2002. Physician-assisted suicide is also allowed for only Dutch residents. In Holland, children as young as 12 can request euthanasia, but parents or guardians must consent until they reach the age of 16. Sources: The Oregon Death with Dignity Act: A Guidebook for Health Care Professionals, Oregon Department of Human Services. Pharmacy dispensing record, The Government of the Netherlands, Newsweek.

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only physicians, but also nurse practitioners and pharmacists. The proposed legislation did not go as far as the recommendations made by a joint parliamentary committee, which said that a patient’s condition to qualify for medically-assisted death should not have to be terminal, that patients with mental illness should not be denied the right as long as they are deemed competent, and that patients with dementia can provide prior consent after diagnosis and while still competent. The panel also said teens and children should have the right to assisted dying, but the government must clarify the term “mature minor.” While the government began the process, many pundits predict the fuzziness of the law means continued legal challenges.

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ON THE COVER | COMPOUNDING PHARMACIES

Compounding: A vital alternative for patients Bustling Victoria Compounding Pharmacy supplies specialized compounds across BC By Matilda Meyers

“How do you treat a boa constrictor with pneumonia?” asks Dr. John Forster-Coull, pharmacy manager and owner of Victoria Compounding Pharmacy. While an unusual question, this isn’t some sort of joke to be followed by an amusing punch line, but an actual conundrum his pharmacy once grappled with.

Both iguanas and pigeons enjoy raspberry and cats particularly like their “really fishy fish” flavour. “We’re like a veterinary Baskin Robbins,” Forster-Coull jests. “People can really treat their animals and give them a good quality of life.” He finds veterinary compounding extremely satisfying and over the years has received many letters of gratitude from pet owners. These notes and photos of hundreds of animals they have treated decorate the pharmacy counters.

Forster-Coull says the answer was a treatment called “slow release mouse” and involved injecting antibiotics into a frozen mouse. The snake ate the mouse and the medication was slowly released throughout its body as the food was digested.

One particularly touching photo depicts a dog with a large grin wearing a birthday hat and sitting beside a cake decorated with candles. “Thank you for giving Hoover his 11th birthday!” the caption reads. “It’s really nice to know that you’re making a difference,” Forster-Coull says. Dr. Dan Thompson from Lakehill Pet Clinic has used Victoria Compounding Pharmacy extensively since he started practicing in Victoria 25 years ago. He describes his experience with them as excellent and often relies upon their valuable advice.

The pharmacy boasts a list of unusual patients with unique health-care needs, including a tarantula with an infection and a wolf eel named Igor that required a special antibiotic dip. Lemurs, ferrets, harbor seals, sheep, goats, birds, rats, horses, dogs and cats are also among its other animal patients. “We have thousands of veterinary clients who really couldn’t take care of their animals without a compounding pharmacy,” ForsterCoull explains. This is because the pharmacy can create exact doses based on an animal’s size as well as a multitude of special medications including injections, transdermal gels, eye drops and even chewable treats in more than 50 different flavours. For example, a marmoset loves the flavour of green apple, while goats prefer malt.

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Dr. Forster-Coull worked at intensive care units at both Royal Jubilee and Victoria General Hospital before becoming the pharmacy manager of Victoria Compounding Pharmacy in 2001 and then the owner/manager in 2007.

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“We’re giving far more sophisticated medications to animals these days,” Thompson says. “And I have faith that if they compound a medication it’s going to be what I’m looking for.” He refers about 20 to 40 pet owners a month to the pharmacy and receives great feedback. The ability to personalize medication reduces stress for both pets and their owners, according to Thompson. This is especially important for long-term ailments such as Cushings or Addison’s disease, which require frequent adjustments. Lori Fenner is a specialist with the Victoria Police Department. For the last 13 years, she and her parents have been looking after multiple special needs cats in their spare time. The family adopts cats that have ailments such as chronic kidney disease or rare forms of cancer and might otherwise be euthanized because no one else wants them. Right now they have eight cats and are devoted to working with veterinarians to give them a second chance and a good quality of life. Fenner gets specialized medication for her animals from the Victoria Compounding Pharmacy on a weekly basis. “The pharmacy is so important to us and they have been incredible,” Fenner says. “John’s staff are a wealth of information. They’re very thorough in what they provide to us and very accessible.” She wishes more veterinarians would promote this form of medication access, as many pet owners aren’t aware it exists. Veterinary compounding makes up about 30 per cent of Victoria Compounding Pharmacy’s business. The remainder caters to human patients, with hormone replacement therapy (HRT) making up about 25 per cent, pain management making up about 15 per cent and the final 30 per cent being general compounding, such as dermatology medication, pediatric suspensions, eye drops and erectile dysfunction medication. They also dispense commercially manufactured medications and a small selection of overthe-counter medication.

Some of the staff at the Victoria Compounding Pharmacy include (from left to right) pharmacist Sarah Redding, assistant Liz Gardner, technician Jenn Foster, pharmacist Caren Heughan, owner/manager Dr. John Forster-Coull, technician Sheena Chapman, assistant Gemma Faasse and assistant Melanie Bryant. Other staff not pictured are technician Roberta Cox and assistant Chris Innes.

Silvia Marcolini is a 64-year-old patient receiving HRT medication from the Victoria Compounding Pharmacy for more than eight years. The pharmacy creates a transdermal gel for Marcolini that she rubs on her arms and inner thighs each morning. She noticed an improvement in her symptoms immediately. As the owner of Café Brio in Victoria, Marcolini relies heavily on the medication to help her cope with her high stress job and also combat the mood swings, night sweats and insomnia that accompany menopause. Commercially available HRT medication includes either patches or pills. She decided against both of these because they cannot be personalized and taking the drugs orally means more side effects. “The pills aren’t made for you, they’re made for everybody,” Marcolini says. Initially, her doctor, naturopath and the pharmacy all worked together to develop a specific regime for Marcolini and now they continue to monitor her bloodwork and adjust her preparation accordingly. The pharmacy also helps patients manage complex nerve pain syndromes resulting from neck, back and shoulder injuries. They combine multiple medications together into a transdermal analgesic gel that penetrates through the skin into the nerve area. “If you take those drug combinations orally you would be pretty spacey and dopey,”

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Forster-Coull explains. “Using transdermal therapy is a huge benefit to patients. They wouldn’t be able to function without it.” Compounding pharmacies also help ensure continuity of care for patients during periods of drug shortages or when a manufacturer decides to stop producing a particular drug altogether. Forster-Coull says two examples of this are phenazopyridine, a common medication for urinary tract infections, and disulfiram, which is used for the maintenance of abstinence from alcohol. Despite public demand for both products they are no longer commercially available in BC and can only be obtained through compounding pharmacies. During 2010 and 2011, Forster-Coull said his pharmacy stepped up and was able to help a large number of other pharmacies around the province by compounding medications such as amitriptyline, metronidazole and tetracycline that were unavailable from the manufacturer at that time. He has noticed drug shortages overall have become increasingly common in the past decade and compounding pharmacies are vital in lessening the impact on patients. A resurgence in compounding Victoria Compounding Pharmacy first opened in 1910. It is the oldest pharmacy in Victoria and one of the oldest in BC. “Essentially, what they were doing in 1910

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ON THE COVER | COMPOUNDING PHARMACIES

we’ve kept on doing,” Forster-Coull explains. “We’re just far more scientific about it and hopefully we’re better at it.”

choose them because they have the staff, experience and infrastructure in place to produce even a complex compounded preparation in under an hour if necessary. “The model was always there, I just turbocharged it,” Forster-Coull says.

He says commercial drug manufacturing started to really grow in the 1950-60s after World War II and ramped up in the 1970-80s. Since the 1980s there has been a resurgence of traditional compounding pharmacies.

He spends a lot of time pounding the pavement to build relationships with local health-care practitioners, encouraging them to refer him business. For example, Forster-Coull will target physician’s offices or veterinary clinics with a list of compounds he can create that might help them, accompanied by evidence-based medical journal articles to support his suggestions.

This is due to demand from the public for specialization and the understanding that personalized medicine is better for patient care. “What compounding offers is individualized care,” Forster-Coull says. “Patients can get far more options than from a commercially available drug.”

Complex compounding

Commercial medicines may contain flavors, preservatives, dyes and binders. If a patient is allergic to any one of these ingredients, using that medicine could result in unpleasant side effects or life-threatening reactions. Compounding pharmacies can prepare pure pharmaceutical products that are free of materials to which a patient is known to be allergic or intolerant. Visually, the pharmacy pays homage to its heritage, with a fascinating array of antique chemical vials, prescriptions and paraphernalia decorating many shelves around the store. The pharmacy has a total of 10 staff members. In addition to himself, ForsterCoull employs two full-time pharmacists, three registered technicians and four assistants. He says that’s a lot of staff for a 1,500 square foot pharmacy. The business is viable because compounded medication is often more expensive than traditional medication due to the high labor component.

Almost every pharmacy in BC can do some level of compounding. The difference between a regular pharmacy and a compounding pharmacy is the level of complexity. Victoria Compounding Pharmacy has approximately $150,000 worth of equipment, $200,000 worth of chemical inventory and 10 experienced compounders. It also adheres to strict processes and procedures and follows quality control measures each step of the way. This includes calibrating every scale each day, using the correct safety equipment and documenting everything including fridge temperatures, who made the compound, what process or equipment they used, material weights, lot numbers and more. Because of its solid infrastructure, up to 30 per cent of the pharmacy’s business comes from corporate compounding with major chains as well as numerous independent pharmacies, physician’s offices, private operating rooms, private clinics and veterinary clinics.

“You’re paying for the skill, training and service level of the compounders,” Forster-Coull says. “The materials used to compound the product may cost very little but it could take two or more hours to make and may require a $5,000 piece of equipment.”

The pharmacy ships its compounds all around BC and each pharmacy that receives the preparations dispenses them to their own patients. This allows each pharmacy to maintain its own patient record and relationship with its patients to ensure continuity of care.

He says the pharmacy’s business model is “High-quality products, high quality service and speed.” Corporate clients

Forster-Coull says compounding is much more difficult than people imagine. “To do compounding properly you have to be

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Pharmacist Caren Heughan is the second longest serving member of staff at the Victoria Compounding Pharmacy. Owner/manager Dr. John Forster-Coull hired her in 1999 after she graduated from university.

a very detail-oriented person,” he says. “Compounding is like neurosurgery, every physician can perform it but if it’s you or your family, you want someone who does it every day – for a living – as opposed to someone who just dabbles in it.” Forster-Coull says pharmacists can do training through several different avenues, including the Professional Compounding Centres of America, Medisca pharmaceuticals, Xenex Labs Educational Program and also through UBC as an undergraduate elective. Forster-Coull grew up in Victoria and completed both his undergraduate pharmacy degree (1988), pharmacy residency at St. Pauls Hospital (1989) and

Doctor of Pharmacy degree (1995) at UBC. He worked in the intensive care units at both Royal Jubilee and Victoria General Hospital before becoming the pharmacy manager of Victoria Compounding Pharmacy in 2001 and then the owner/manager in 2007. The PharmD training comes in very handy for compounding work. “Historically, people think that having a PharmD is purely for hospital work but to tell you the truth I use the skills I learnt more here than I ever did in the hospital,” Forster-Coull remarks. “In community pharmacy it’s just you, particularly if you’re working in a small town. You are it. You have to decide. You have to make the decision if the prescription is safe. That’s why community pharmacists are such good problem solvers.” One of the challenges compounding pharmacies will be facing in the next few years is increasing regulations. Forster-Coull is on the Extemporaneous Compounding Task Group – a group established by the College of Pharmacists of BC to help draft the regulations. The group will provide recommendations to the Board on issues relating to pharmacy compounding, standards and compliance with those standards.

Approximate breakdown of Victoria Compounding Pharmacy’s business

Medications sold

80% compounded medications 20% t raditional manufactured medications

“There is a line of protecting the public and still allowing the viability of the practice,” he says. “If you overregulate and make it so difficult and so costly to produce a compounded product, nobody will do it. And then essentially you’ve denied the patient population a viable alternative for themselves.” The desire to increase regulations in BC follows huge problems and a number of deaths in the United States in recent years due to inappropriate sterile compounding. Another issue for compounding pharmacies is the pricing structure for patients who are fully covered under PharmaCare for a benefit drug. Forster-Coull says the price is set too low and under the PharmaCare agreement he is not allowed to charge patients any extra to compound the drug in the same way that he can for patients who are paying out-of-pocket or who are covered by their extended health benefits. As a result, he cannot afford to make the compound and may have to turn them away in order to ensure that his business remains profitable. “For some patients I will do it and hope to break even,” Forster-Coull.

Compounded medication breakdown

30% veterinary compounding 25% hormone replacement therapy (HRT)

15% pain management 30% general compounding, such

as dermatology medication, pediatric suspensions, eye drops and erectile dysfunction medication

How medication is dispensed

70% dispensed out of the Victoria Compounding Pharmacy

Owner/manager Dr. John Forster-Coull finds veterinary compounding very satisfying and over the years has received many letters of gratitude from pet owners.

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30% shipped to corporate clients

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TELEMEDICINE

Telemedicine clinics in pharmacies help alleviate physician shortage Several BC pharmacies join growing trend across Canada to provide medical services via video chat By Matilda Meyers For several years the city of Kamloops in south central BC has received attention for its severe shortage of family doctors. Last November, local news reported that about one third – or 30,000 people – in the city were without a family doctor. Two Kamloops pharmacies are hoping to alleviate this issue with the introduction of telemedicine clinics inside their pharmacies. Kleo’s Pharmacy Remedy'sRx and Kipp-

Mallery Pharmacy are both in the process of setting up what’s called a “patient studio” and will soon be accepting patients. The service is provided by Toronto-based company MedviewMD and gives patients remote access to a doctor or nurse practitioner, depending on their needs. Kleo Dimopoulos, pharmacy owner and manager of Kleo’s Pharmacy Remedy'sRx, explains that patients can phone or just walk

into the pharmacy to make an appointment. A licensed practical nurse (LPN) and a nursing assistant will be onsite at the clinic to guide the patient through the consultation. The nursing assistant will greet the patient in the waiting area, check their status and identify their needs. This data provides the initial input for a real-time evaluation with a doctor. The patient is then taken into the studio for the consultation, where the LPN acts as the hands of the physician, who is connected via a video screen. The clinic is equipped with instruments including a camera (with video and photo capabilities), stethoscope, oxygen monitor and blood pressure monitor. Other equipment, such as a device to test cholesterol levels, can be added in the future if necessary. The LPN can take the patient’s vitals, such as blood pressure or heart rate, and provide these to the doctor via the computer system. This information is also kept on file and available for future visits. If the patient has an ear infection, for example, the LPN can look into the patient’s ear using a camera. The visuals are broadcast to the doctor and a photo taken for future reference.

Kleo’s Pharmacy Remedy'sRx is installing a telemedicine clinic in its pharmacy to help the estimated 30,000 people in Kamloops without a family doctor. Owner and pharmacy manager Kleo Dimopoulos leases the equipment from MedviewMD, a Toronto-based company that provides the clinic service.

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MedviewMD is in charge of hiring all staff, including the onsite nurses and the doctor or nurse practitioner located remotely. Dimopoulos says the majority of remote

health practitioners will be located in BC but the company does have practitioners across Canada. Each pharmacy leases the equipment from MedviewMD and provides the company with space to set up in the clinic within their pharmacy, at no charge. Dimopoulos is on a monthly lease for the equipment and will own the equipment after five years. It is a symbiotic relationship of sorts, with Dimopoulos saying, “We will work with each other and help each other out.” As with a regular doctor’s office, the visit is paid for either through the provincial medical services programs or, if it’s something not covered, is charged to the patient. The pharmacy does not receive any money from the visit but anticipates that patients may fill prescriptions at the onsite pharmacy for convenience. Having only opened his pharmacy in September 2015, Dimopoulos is optimistic that the clinic will help him stand out from other more established pharmacies in town and stimulate business growth. “We are a new pharmacy and in order to establish ourselves I figured it would be a good thing to bring people in,” he says. “It can be hard to compete with the big box stores and it can be challenging for us to get that foot traffic.” If the clinic is successful in boosting his business he may consider increasing the pharmacy hours. Dimopoulos has been a pharmacist in Kamloops for over 20 years and for the past decade patients have asked him about available physicians. He hopes the clinic will give orphan patients another option and that they will appreciate his efforts. “I don’t have a physician and there are a lot of people in Kamloops that don’t,” Dimopoulos says. “I feel like this could really help our community.” So far the response from patients has been extremely positive, with numerous people already coming into the pharmacy each day to go on a waiting list. Dimopoulos says it could also benefit physicians nearby as it will help share the load, especially if they need to take leave and cannot find a locum. He has also received dozens of calls from interested pharmacists who read about the clinic in recent news stories. The common question they have is whether there will be enough doctors and nurse practitioners available to sustain patient demand, given

Kleo Dimopoulos only opened Kleo’s Pharmacy Remedy'sRx, the pharmacy he owns and manages, in September 2015. Dimopoulos is optimistic that the clinic will help him stand out from other more established pharmacies in town and stimulate business growth.

the physician shortage in BC. Dimopoulos also shared this concern and spoke with colleagues who have telemedicine clinics in eastern Canada to determine if it was a viable business decision. “They indicated there was some hiccups in the beginning – which I expected as it’s a new thing – but they’ve seen some good results,” he says. These pharmacies saw their own business increase by five to 10 per cent after the clinic was installed. “If I can get at least that I’ll be happy and then I can work from there to increase it,” Dimopoulos says. MedviewMD has also promised a doctor or nurse practitioner will be available whenever the pharmacy is open and that it will see a maximum of six patients per hour. This number will be less in the beginning as it takes time for new patients to be added to the system. According to MedviewMD’s website there are 13 clinic locations in Canada that are open now or opening soon. Just three of these are in BC – two in Kamloops and one at Langley IDA Pharmacy. “We’ll be the first ones in BC,” Dimopoulos says. Another 17 locations are under development, including one in Chilliwack. He believes it’s a logical choice to locate a telemedicine clinic within a pharmacy. “A

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pharmacy is an ideal place, where people already come to ask advice,” he says. Dimopoulos says MedviewMD is approaching independent pharmacies such as his because they don’t sell as many over-the-counter medications and therefore have more space inside the store. The clinic in Kleo’s Pharmacy was scheduled to open at the end of April and will be accessible during the pharmacy’s hours of operation: Monday to Friday from 9 a.m. to 6 p.m. and Saturday from 9 a.m. to 3 p.m. Dimopoulos says it will treat many ailments similar to that of a walk-in clinic, such as ear and bladder infections, prescription renewals, colds and flu, laboratory work and WorkSafeBC visits. Of course there are select services it cannot provide, such as prescribing narcotics or urgent care, including heart attacks and major cuts. Patients should visit the emergency room for urgent care and if they do visit the clinic, staff will call them an ambulance. Because there will be an LPN present, Dimopoulos doesn’t expect older patients to be deterred by the new technology. “The nurse can help the patient talk to the doctor and I don’t think it will be too difficult,” he says. “It’s pretty much like Skype or FaceTime.”

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BOARD ELECTIONS

Gutenberg and Wigston elected Congratulations to Linda Gutenberg and Jamie Wigston, who were elected to the BCPhA Board of Directors on election day, Friday, April 15. Both positions are for three-year terms running from Sept. 1, 2016, to Aug. 31, 2019. Gutenberg is director of pharmacy at Forewest Holdings in Langley and Wigston is a pharmacist at West End Medicine Centre in New Westminster. This year we had a total of seven candidates run for the two positions. Thanks to all the candidates for putting their names forward and to everyone who took the time to participate in the election process. We spoke with both of our new Board members to find out why they ran for election and what makes them tick.

have to say it was mainly so I could play a larger part in shaping pharmacy practice in BC (rather than just complaining about it). In addition to that, I would really like to educate the public more on what it is we, as pharmacists, actually do. What does the BCPhA need to achieve in the next three years? I think the BCPhA needs to continue advocating for the pharmacy profession by pushing for an increase in our scope of practice and at the same time ensuring we are adequately compensated for that increased scope in order to keep it feasible. What are pressing issues facing pharmacy in BC? I believe one of the main issues is the fact that we are constantly given more responsibilities (whether bureaucratic or clinical) yet not remunerated proportionally. As a result, many pharmacies are not able to allocate additional pharmacist hours. This increases the level of stress on pharmacists and adds the possibility of mistakes. What is the most common misconception about pharmacists? I think the public still holds the same misconception that it has for years, which is that we only fill a vial with pills, stick a label on it and then hand it to them.

Jamie Wigston Pharmacist at West End Medicine Centre (New Westminster)

What is the quality you most admire in a person?

Why did you want to be on the BCPhA Board?

I would have to say honesty, but not in terms of telling the truth (which is important), more so in terms of being honest with yourself and not trying to be someone you're not.

I would say for the fame and fortune, however I was told after the fact that I will get neither of those, in which case I would

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What do you consider your greatest achievement? I would probably have to go with graduating from pharmacy school and subsequently passing my licensing exams. However, if I was going to be completely honest (as I said was important above), I'd say it was winning enough radio contests last year to buy myself a large new TV. Which talent would you most like to have? I'd really like to have a green thumb, and be able to grow things in a garden. I mean, I bought some magic beans from this traveling salesman not too long ago and he said they'd grow overnight, but that was three months ago, I hope he didn't cheat me. The joke is on him though if he did. The cows I traded him for it were just two pigs I painted black and white. What is your most treasured possession? I'm going to play two truths and one lie for this question. My three most treasured items are my pharmacy and biology degrees, as well as a large woven Harry Potter blanket that I have since hung on my wall as "art." If you guessed the biology degree as the lie, you were correct. That thing is just an expensive piece of paper at this point. If you could change one thing about yourself, what would it be? I would probably try and change how lazy I can be on occasion. I mean it gets pretty bad, sometimes I'll be answering a question and I'll just stop in the... What is it that you most dislike? Tomatoes. No funny story. Just keep those tomatoes away from me.

the BCPhA Board and I believe I can be that voice. What does the BCPhA need to achieve in the next three years? BCPhA needs to remain active in supporting the advancement of pharmacy practice through changes in scope of practice and new practice areas, such as prescribing authority. We also must ensure that the government appropriately compensates pharmacy in these new areas. What are pressing issues facing pharmacy in BC?

Linda Gutenberg Director of Pharmacy, Forewest Holdings (Langley) Why did you want to be on the BCPhA Board? I feel that having a strong voice for independent pharmacy is needed on

from one container to the other. Pharmacists must continue to educate the public with every interaction that we are doing much more with each fill of medication. What is the quality you most admire in a person? A strong work ethic. What do you consider your greatest achievement? Working to make a significant change in my health. Which talent would you most like to have?

Changes that the College is looking to introduce to the Health Professions Act and the bylaws will add unnecessary burden to pharmacy practice. We need to have a strong voice to make sure these changes are done in an appropriate manner that does not just add more regulation.

Playing the piano.

What is the most common misconception about pharmacists?

I would like to be more organized.

The most common misconception about pharmacists is that all we do is pour drugs

Apathy.

What is your most treasured possession? My family. We need to cherish every day we have together. If you could change one thing about yourself, what would it be?

What is it that you most dislike?

You spend your life helping others. It’s now your turn to receive the right advice.

We Have the Perfect Prescription for Your Home. Home Protect Rx is a Comprehensive Home Insurance Policy providing Guaranteed Replacement cost coverage against loss or damage to your home and replacement cost coverage to your personal property. In addition to our exceptional policy features, as BCPhA members you will receive benefits not available to the general public: Premium Claims Service 24 hour emergency claim service; Claims advocate who works for you to ensure a quick and fair settlement ■ Discounts up to a maximum of 70% in savings ■ Policy Extensions, Optional Coverage, Convenient Payment Options ■

Contact Doug Chan for your no obligation quote. TEL: 604 255 4616 TOLL FREE: 1 800 255 6789

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ANNUAL CONFERENCE

BCPhA Annual Conference draws near

Kevin Davies, author of The $1,000 Genome and Cracking the Genome, kicks off our Annual Conference as the keynote speaker on Friday, May 27. The conference will be held in Kelowna at the Delta Grand Okanagan Resort and Conference Centre from May 26 to 28. This year's theme is "The DNA of Pharmacy." It represents how advances in genetic testing can shape the future of pharmacy patient care and how pharmacists ensure mastery of the core business building blocks – or DNA – of community pharmacy.

Davies is a British author, editor and publisher who specializes in medical genetics, personalized medicine and the Human Genome Project. Read “Meet Kevin Davies” on page 5 of The Tablet to learn more about him.

on Friday evening and this year’s Annual General Meeting will be held on Saturday morning. The following pages include highlights of the sessions and speakers on Friday and Saturday, together with the full conference schedule.

The theme for this year’s Thursday evening trade show is The Great Gatsby. Attendees are encouraged to dress in 1920s style attire reminiscent of the famous movie/novel. For the ladies, think glamour: Sparkles, gloves, headpieces and fringing. For the men, think dapper: Fancy suits, vests, hats and bow ties.

To have handy access to the full schedule and information about all of our speakers while you’re at the conference, download our 2016 event app. You can also create a profile and connect with other attendees. Just visit the app store on your phone and search for BCPhA.

This themed night kicks off the conference at 6 p.m. on Thursday, May 26 and features about 30 exhibit booths, great food and exciting door prizes. It will be an opportunity to network with your colleagues and browse new products and services.

Follow us on Twitter @bc_pharmacy and use #DNAofPharmacy during the conference to get involved in the conversation. For more information or to register, please visit www. bcpharmacy.ca/conference.

The 2016 BC Excellence in Pharmacy Awards will be presented at the Awards Gala

Some of our scheduled speakers Keynote Speaker, Author of The $1,000 Genome Kevin Davies, Ph.D. In his presentation, author and journal editor Kevin Davies will revisit the drama and ramifications of the Human Genome Project and lay out the stunning progress in DNA sequencing and genomic analysis since then. The

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cost of sequencing a human genome has plummeted in that time from hundreds of millions of dollars to a mere $1,000. The past few years have also seen the rise of direct-to-consumer genetic testing, which has empowered many people to explore their personal genomes. Davies will provide insights on personalized medicine, clinical success stories, the controversy surrounding consumer genetic testing and the potential of pharmacogenomics testing to impact the role of pharmacists. Read “Meet Kevin Davies” on page 5 to learn more about him.

ANNUAL CONFERENCE

The Future of our Workforce: Bridging Expectations of Employers and Young Professionals Eric Termuende By 2025, 75 per cent of the workforce will be Generation Y. With the average tenure of a Gen Yer being just over two years in a company, there are a few questions that we should consider. How can employers strengthen institutional memory by developing a sustainable employee base? How can pharmacy employers reduce the time, energy and finances lost when the recruiting cycle becomes shorter and shorter? How are students being educated about their careers and how can we engage them once they join our companies? What should students and new graduates need to know to get the most out of their education as they prepare for the workplace?

College of Pharmacists: Issues and Topics in Pharmacy Practice and Regulation Suzanne Solven Solven will address issues and hot topics in pharmacy practice in BC. The session will discuss certified pharmacist prescribing, medical assistance in dying, DrugSafeBC, the Methadone Maintenance Treatment (MMT) action plan, medical marijuana and telepharmacy. This a great opportunity to learn more about ongoing College initiatives or ask questions and get to know the College a little better.

Termuende will outline how to better attract, engage and retain employees of all generations. The future of work is happening now and businesses must be sure that the communication of their culture is being done properly to attract the best possible employees for them. Eric Termuende is a director and co-founder of Gen Y Inc., an international culture group based in Canada. Termuende helps lead business development and thought leadership for Gen Y Inc. and speaks across the world about the future of work and workplace culture. His leadership in entrepreneurship is among several reasons why he was invited to be a Canadian delegate participating in the G20 Young Entrepreneurs Alliance, where he now sits on the Leadership Committee. Termuende is recognized as one of only ‘100 emerging innovators under 35’ globally by American Express and an active ‘Global Shaper’ with the World Economic Forum.

Suzanne Solven is the deputy registrar of the College. She has more than 25 years of pharmacy and leadership experience and is dedicated to continuous learning and building impactful pharmacy policies that make a difference in the health and safety of patients. In her role, Solven helps execute the College’s strategic plan and leads its complaints and investigations unit. She was also instrumental in the development of the organization’s MMT action plan and robbery prevention initiative. Solven has also worked with the provincial government, leading many inter-professional drug policy development initiatives. When she’s not working, you will find her watching one of her three kids’ hockey, soccer or baseball games.

Private Payers: 2015 in Review - the Good, the Bad and the Very Expensive

where the worlds of pharmacy, pharmaceutical companies and benefits administration intersect and the pressures these industries will all feel as costs continue to rise.

David Willows

David Willows is the vice president of strategic market solutions at Green Shield Canada (GSC). While it might sound like slick marketing language, “Vice president of strategic market solutions” means that Willows leads product development, which includes both pharmacy strategy and the traditional marketing function. Prior to GSC, Willows spent five years working as the Toronto health and benefits practice leader for Aon Consulting and then the merged Aon Hewitt organization. Over the past 20 years he has split his time between the carrier and health benefits consulting community, primarily focusing on attendance and disability management, but more recently focusing on the broader health management issues facing Canadian employers.

David Willows returns to our Annual Conference to share his data and perspective from the world of private payers. Willows will comment on the roots of Canadian health benefits plans, discuss their purpose in modern times and highlight findings from Green Shield Canada’s 2015 health study. The study provides insight into private payer spending and the strategies being introduced in the benefits carrier industry to manage employee health and overall program costs. Willows will examine

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ANNUAL CONFERENCE

Pharmacists in COPD Management Ajit Johal Chronic obstructive pulmonary disease (COPD) is officially the fourth leading cause of death in BC. More importantly, the rate of COPD mortality is increasing with time and our aging population. It is on track to become the third leading cause of death in Canada by the end of the decade. Add to this the fact that roughly 1.6 million Canadians with COPD remain undiagnosed, and that overall one in four Canadians over the age of 35 will develop COPD in their lifetime. It is obvious that COPD will be one of the major health concerns facing Canadians over the coming years. As both accessible and knowledgeable health-care providers, pharmacists are ideally situated to make a difference for this population. This session will discuss the pathophysiology of the

Keeping Seniors Healthy Through Vaccination Dr. Janet E. McElhaney Dr. Janet McElhaney is the Health Sciences North (HSN) Volunteer Association Chair in Healthy Aging, vice president of research and scientific director for the Advanced Medical Research Institute of Canada, consulting geriatrician and medical lead for Seniors Care at HSN and a professor at the Northern Ontario School of Medicine. McElhaney's research interests include the impact of immunosenescence, or changes in the immune system due

Smoking Cessation: Practical Implementation Bryan Gray Gray’s presentation will focus on the practical and operational aspects of implementing a smoking cessation program. Since there is a robust number of resources and healthcare clinicians available to help with cessation, his presentation will focus on differentiation. Specifically, combination therapy, point-of-care testing and pharmacogenomics. The session will include a discussion of operations, logistics, sustainability/viability/profitability, while also reflecting on past lessons learned.

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disease, the novel medication devices on the market to treat COPD and how pharmacists can use their medication management skills to make a difference for COPD patients. Ajit Johal graduated from the Leslie Dan Faculty of Pharmacy program at the University of Toronto in 2012. He then began working as a community pharmacist at Wilson Pharmacy in Port Coquitlam. Following his passion for pharmaceutical care, Johal built – and continues to expand – the pharmacy's clinical services program. Today the pharmacy medication management program spans a large demographic and provides services to a diverse patient population. He continues to promote the profession and serves as a mentor for future pharmacists. In 2014 Johal won the Pharmacy Practice Educator of the Year Award from the UBC Faculty of Pharmaceutical Sciences for demonstrating outstanding leadership and commitment to student learning. He has made presentations and led workshops for Coast Mental Health, BC Housing and Drug Trading and is currently a clinical instructor at UBC.

to age, on the immune responses to vaccination, immunologic biomarkers of protection mediated by vaccination and how vaccination plays a role in preventing disability in older adults. She has 25 years of experience conducting clinical research studies. McElhaney has been an investigator on large international clinical trials, chaired a publication steering committee for a large influenza vaccine trial, participated in research ethics boards and been a member of several data safety and monitoring boards. She has also been a member of the Canadian Institutes of Health Research Institute of Aging Advisory Board, and serves on the editorial boards of The Journal of Immunology and The Journal of Infectious Diseases.

Bryan Gray is a practicing pharmacist, owner of River Terrace Medical Pharmacy and a managing partner of Corozon Consulting. He lives and works in Thunder Bay, ON. Gray completed his pharmacy education at Dalhousie College of Pharmacy in Halifax, NS. Upon graduation he began a master of business administration at Lakehead University. He has been an active advocate in the profession, including: committee member for the Ontario Pharmacists Association (OPA), board member with the Canadian Foundation for Pharmacy (CFP), blogger for Pharmacy Practice+ and Canadian Pharmacists Journal author. Gray has been recognized for his accomplishments with awards including: Commitment to Care and Service Leadership Award (OPA), Wellspring Leadership Award (CFP) and the New Practitioner of the Year Award (Canadian Pharmacists Association).

Conference schedule Thursday, May 26 6:00pm - 9:00pm

Trade show and networking (with stand up dinner)

Friday, May 27 7:15am - 8:30am

Breakfast buffet

8:45am - 9:00am

Welcome and opening remarks

Geraldine Vance and Allison Nourse

9:00am - 10:30am

The $1,000 Genome and the Road to Personalized Medicine

Keynote speaker: Kevin Davies

10:30am - 10:45am

Break

10:45am - 11:45am

Genomics for Precision Drug Therapy in the Community Pharmacy - Phase 1 results

Dr. Corey Nislow

11:45am - 12:45pm

The Future of Pharmacy : Student Presentations

Moderator: Dr. Alan Low

12:45pm - 1:45pm

Lunch and update from the Ministry of Health

Barbara Walman

Exploring the Innovation in Non-insulin Glucose Lowering Medications for Type 2 Diabetes

Cristi Froyman

2:00pm - 3:00pm (concurrent sessions)

or Integrating Patient Safety into your Pharmacy's DNA

Karen Wolfe

3:00pm - 3:15pm

Break

3:15pm - 4:15pm

College of Pharmacists: Issues and Topics in Pharmacy Practice and Regulation

Suzanne Solven

Friday evening 6:00pm - 6:30pm

BCPhA Awards reception

6:30pm - 9:30pm

BCPhA Awards dinner

Emcee: Mark Dickson

Saturday, May 28 7:15am - 8:30am

Breakfast buffet

8:35am - 8:45am

Opening remarks

Geraldine Vance and Randy Konrad

8:45am - 9:30am

BCPhA Annual General Meeting

Geraldine Vance and Allison Nourse

The Building Blocks for Effectively Promoting Vaccine Services (workshop limited to 30 participants on a first-come-first-served basis)

Callie Bland

9:30am - 11:00am (concurrent sessions)

or The Future of our Workforce: Bridging Expectations of Employers and Young Professionals

11:00am - 11:15am

Break Private Payers: 2015 in Review - the Good, the Bad and the Very Expensive

11:15am - 12:15pm (concurrent sessions)

Ajit Johal

Lunch Subsequent Entry Biologics (Biosimilars): A 2016 Update

1:15pm - 2:15pm (concurrent sessions)

Dan Martinusen

or Keeping Seniors Healthy Through Vaccination

2:15pm - 2:30pm

Dr. Janet McElhaney

Break Smoking Cessation: Practical Implementation

2:30pm - 3:30pm (concurrent sessions)

Bryan Gray

or The Pharmacist's Role in Self Care

3:30pm - 3:45pm

David Willows

or Pharmacists in COPD Management

12:15pm - 1:00pm

Eric Termuende

Vicki Wood

Conference wrap up

Exact schedule or session titles may be subject to change. Please visit www.bcpharmacy.ca/conference for the most up-to-date information.

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STUDENT SPEAKER SERIES

Pharmacogenomics the future of community pharmacy UBC Sequencing Centre associate director Mark Kunzli shares vision with pharmacy students Once a reluctant student of pharmacogenomics, pharmacist Mark Kunzli is now the area of study’s biggest champion.

through which patient genetic information can be acquired, assessed and used to guide drug therapy decisions.

in securing participants so far thanks to the strong relationships forged between pharmacists and their patients.

Project manager and associate director of the UBC Sequencing Centre, the Faculty of Pharmaceutical Sciences’ pharmacogenomics research hub, Kunzli is working with BCPhA and Genome BC on the current study, “Genomics for Precision Drug Therapy in Community Pharmacy.” The project is the first of its kind in North America. So far the project has secured 200 participants in 33 community pharmacies across BC. It aimed to position the pharmacist as the health-care provider

Kunzli met with a group of pharmacy students on March 18 to share his insights into the project and advocate for the new chapter in health care, as part of the BCPhA’s Speaker Series for UBC students.

“This project validated our initial belief that pharmacists are the right member of the health-care team to introduce pharmacogenomics into everyday care. My pharmacist colleagues were the most important members of the study team, as they engaged, educated and consented their patients to participate in the project. They consistently went above and beyond in addressing barriers to making this project a success.”

Mark Kunzli, a practicing pharmacist and associate director and project manager at the UBC Sequencing Centre, spoke to UBC students as part of the BCPhA Speaker Series on March 18. As a university student sitting in the back row of his pharmacogenomics course, Kunzli never imagined he would one day be involved in a project putting pharmacists at the forefront of implementing pharmacogenomics in practice.

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“It wasn’t too long ago I was a student in Dr. Ron Reid’s pharmacogenomics course, struggling to see how what he was teaching would apply to my practice as a pharmacist,” Kunzli shared with the group. “Yet in 2009, not even a couple years after graduation, I found myself sitting down with Ron talking about how pharmacogenomics in community pharmacy practice was the future of our profession.” After many meetings with Reid and Wayne Riggs, a fellow UBC professor, the trio published their first article on the hot topic in Pharmacy Practice+ in 2012. In their article they wrote that personalized medicine was already a part of pharmacy in the form of medication monitoring and adjustment. Incorporating genomics wasn’t so much a revolution but an evolution of what the profession already did. This led to the establishment of genomics as a key research area in the faculty, the opening of the UBC Sequencing Centre in 2013, and most recently, the collaboration with the BCPhA and Genome BC for the genome project. “The recent completion of this project represents a watershed moment for our profession,” says Kunzli, adding that the genome project has been so successful

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Addressing the group of soon-to-be pharmacists, Kunzli noted that in order for patients to one day have the option of receiving personalized, DNA-specific drug counselling, it was up to pharmacists to change the discussion on how genomics can be used to make medication use safer and more effective. “The trust relationship between a pharmacist and patient is crucial to facilitating that discussion and educating the public,” he says. “You need to be accessible, knowledgeable and able to translate that knowledge in a way that is understood, which is a role pharmacists fill every day.” With Phase 2 of the project set to launch later this year – studying 1,000 patients at pharmacies across Canada – Kunzli stressed the importance of this area of study to the future of pharmacy. To learn more about the genome project, visit the BCPhA website at www.bcpharmacy.ca/genome.

CAREER LISTINGS

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. We have the best pharmacy job board in BC! For the full listings of pharmacy technician and assistant positions visit the Pharmacy Technician Society of BC website at ptsbc.ca 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

be a licensed pharmacist in good standing with the College of Pharmacists of BC. Wages will be competitive and based on experience. Please send resume to rahim_2002@yahoo.com. CHETWYND Pharmacy manager – full-time Looking for a pharmacy manager to work in northern BC with a good pharmacy team. Please send resume to owner Ron Downey at rwdowney@telus.net. Pharmacist – full-time Looking for a staff pharmacist to work with a good pharmacy team. Please send resume to owner Ron Downey at rwdowney@telus.net.

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! Please send resume to Denise Nilsen, regional manager, pharmacy operations at denise_nilsen @owfg.com. GOLDEN Pharmacist – full-time

Peoples Pharmacy, the outpatient pharmacy for the East Kootenay Regional Hospital in Cranbrook, BC, is currently seeking a full-time staff pharmacist. Our pharmacy specializes in long-term care, BC renal program, mental health, addiction services, immunization, sterile compounding, pain and wound care and hormone consulting. Please send resume to peoplespharmacy@telus.net, fax 250.420.4135 or call 250.420.4133.

We are hiring a full-time pharmacist to work in our independently owned pharmacy in Golden, BC, attached to the only medical clinic in Golden. Pharmacy hours are Monday to Friday 9am to 5pm; no weekends or holidays. The wage is $50 per hour with a benefit package. For more information on Golden and all it has to offer, see www.golden.ca. If you would like to apply for this position or need further information, please contact Darren Belik. Please send resume to gourlayscanmore@telus.net or online at www.gourlayspharmacygolden.ca, fax 403.678.3916 or call 403.678.5288.

DELTA

KAMLOOPS

Pharmacist – full-time

Pharmacist – part-time

We are looking for full-time pharmacists for our Lower Mainland pharmacies. Experience with WinRX/Kroll and Microsoft Office (Word, Excel, etc.) are necessary. The successful applicant is required to have at least one year 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, 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. Full medical and dental benefits are provided after a trial period of three months. Please send resume and cover letter to shafik@wescanapharmacy.com.

Manshadi Pharmacy is looking to hire a part-time, motivated pharmacist to work in a well-established independent retail pharmacy. Experience working in a busy pharmacy is a requirement. 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 necessary amenities. Only qualified applicants will be contacted. Please send resume to Missagh Manshadi, pharmacist/owner at missagh@manshadipharmacy. com or online at www.manshadipharmacy.com, fax 1.250.434.2527 or call 1.250.574.0111.

DUNCAN

Pharmacy manager – full-time

BURNABY

Pharmacist – part-time

Overwaitea Food Group, one of Western Canada's leading food and consumer-goods retailers, operates more than 110 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart 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 OFG and make your career prescription complete! We have an opening for a part-time pharmacist position at our store in Duncan. Only shortlisted candidates will be contacted. Please send resume to Gary Go, regional manager, pharmacy operations at gary_go@owfg.com.

We are a clinic pharmacy located in a building in Langley that also houses a walk-in medical clinic and physiotherapy centre. We are looking for a pharmacy manager interested in patient-centred care and developing the business. We're looking for a pharmacist with a strong work ethic, strong customer service and communication skills, and a willingness to work collaboratively to solve patients’ healthcare needs. Candidates with previous pharmacy management experience and proficiency with Kroll are preferred. We offer good working hours, competitive wages and excellent benefits. Interested candidates are encouraged to email a brief cover letter and attach their resume at justin@remedysrxsp. ca. Only shortlisted candidates will be contacted.

ABBOTSFORD Pharmacy manager – full-time, part-time Garden Park Pharmacy in Abbotsford is a longestablished, friendly community pharmacy seeking a pharmacy manager, pharmacist and pharmacy assistants to join our company. Abbotsford is about a 45-minute drive from Vancouver. We offer competitive wages. No Sunday, Saturday, statutory holidays or evenings. All experience levels and new graduates are welcome. Please email your resume to alanchoi5588@yahoo.com, fax 604.746.2825 or call 604.859.3300. Pharmacist – full-time Currently seeking a full-time pharmacist with at least three years’ experience. Please contact by email only. No phone calls. Please send resume to info@ pharmasaveabby.com. Pharmacist – full-time Looking to hire a full-time pharmacist. Experience with HW is a big asset, injection certified, customer service-oriented, excellent communication skills, ability to work as a team member, oriented with the professional services scope of practice and flexible schedule, with some evenings and weekends. Please send resume to Mina Fahim, pharmacist/ owner, at asdm2288@shoppersdrugmart.ca or call 778.321.3960.

We are looking for a strong commitment to customer service and a highly organized individual with excellent communication skills. Requirements: Commitment to high quality of patient care and customer service, efficient in the WinRx system (essential), Italian, Mandarin or Cantonese fluency (essential). Please (only) email your resume and cover letter to arrange an interview. New grads welcome. Please send resume to pharmacy manager Masoud Majlesi at capitollhill@remedysrx.ca or call 604.299.9255. Pharmacist – part-time Looking to hire a permanent part-time pharmacist for an independent pharmacy in Burnaby. Potential to lead to a full-time position. Hours of operation are Mon-Fri 10-6. Knowledge of WinRx is preferred. Must be able to quickly and accurately dispense medications, provide medication reviews and adequately assess for interactions. Applicant must

CRANBROOK Pharmacist – full-time

FORT MCMURRAY Pharmacist – part-time Two permanent part-time positions available. Overwaitea Food Group, one of Western Canada’s leading food and consumer-goods retailer, operates

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LANGLEY

Pharmacist – full-time Seeking a highly motivated, charismatic, driven pharmacist. This position is best suited for individuals with a well-developed business acumen and excellent clinical service skills. Starting wage $31-49/ hour depending on experience and performance.

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Qualifications: Bachelor of pharmacy, licensed to practice in BC, superior interpersonal skills, strong verbal and written communication skills, commitment to providing exceptional customer service, computer proficiency (Kroll), experience/ certification in geriatrics is an asset but not required. Hours: 36 hours/week. Please send resume to pharmacycareltd@gmail.com. Pharmacist – part-time Co-op Pharmacy in Langley is accepting applications for a part-time pharmacist. We provide an excellent pharmacy practice environment with personal growth and career development opportunities. We offer an attractive compensation and benefits package. If you are highly motivated to provide excellent pharmacy care and customer service please send your resume by email at pharmacymgr@otter-coop.com or fax 604.856.3101. Pharmacist – part-time Permanent part-time position at a Langley Pharmasave. Looking for someone who enjoys dealing primarily with seniors. Please send resume to pharmasavemurrayville@gmail.com. LOWER MAINLAND Pharmacist – full-time We are looking for a full-time pharmacist for our Lower Mainland location. Experience with WinRX and Microsoft Office are a great asset. A successful applicant is required to have at least one year of experience working in a community pharmacy and to be injection certified. You must also have a good working knowledge of PharmaCare and third party billing policies, 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 for pharmacists are between $38-40/ hr depending on experience. Full medical and dental benefits are provided after a three-month trial period. Please send resume and cover letter to careers@ wescanapharmacy.com. Pharmacist – part-time 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 resume to Shawn Sangha, pharmacy operations manager at ssangha@londondrugs.com.

NAKUSP

We require part-time or full-time pharmacist for busy independent North Vancouver Pharmacy. If you are looking for a great work environment with a strong clinical role coupled with dispensing, interdisciplinary collaborative focus, competitive pay and consistent enjoyable work, please apply. Please send resume to nvpharmacy1@gmail.com.

Pharmacist or pharmacy manager - full-time Pharmacist or pharmacy manager position available in picturesque Nakusp. Try a change of pace in this beautiful and relaxed West Kootenay town located only 2.5 hours from the Okanagan. Enjoy skiing, hiking, fishing and the famous hot springs in this spectacular, unspoiled lakeside paradise. Talk about job satisfaction. Come practice in a community which really appreciates its pharmacists. Work as an integral part of the health-care team, where you get the support you need to practice patient-oriented pharmaceutical care. You control your schedule and vacation (no evenings, Sundays or holidays). Competitive wages and benefits. Please send resume to Troy Clark at pp321@pdmstores.com, call 250.265.2228 or fax 250.265.2218. NANAIMO Pharmacist – part-time Part-time pharmacist for two to three days per week and every third weekend for pharmacy outside Nanaimo. Kroll experience required. Busy dispensary with full support. Please send resume to steveer217@ gmail.com. NEW WESTMINSTER Pharmacist – full-time 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. Flexible schedule, with some weekends and evenings. Please send resumes to sabeeh@globalhealthmanagement.ca.

Pharmacist – full-time

Pharmacist – full-time, part-time, relief We are looking for a full-time/part-time pharmacist for a small, independent compounding pharmacy in the Lower Mainland. Experience with WinRx preferred but will train right candidate. Must be injection certified, authorized to dispense Methadone, good knowledge of PharmaCare and third party billing, clinically oriented, enjoy doing medication reviews, strong verbal and written communication as well as organizational skills, able to perform in a fast-paced environment, must be flexible and a team player, and be business minded with a patient-focused attitude. This is an ideal position for someone looking to further their knowledge of pharmacy and grow with a company. Above average compensation and benefits. Please send resume to alouettepharmacy@gmail.com. Pharmacist – full-time We are looking for a pharmacist to join our growing company. We are an independent, community-based pharmacy providing patient-centered care. We require

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injections; fluent in English. Both part and full-time schedules available, weekdays from 6am to 2pm and weekends from 6am to 2pm, with flexible weekly shift selection. Work environment consists of long-term patients, experienced support and management staff. Position offered includes: annual paid vacation, a guaranteed employment contract, compensation ranges from $40 to $45 per hour, contingent on job performance. Please send resume to Venus, operations manager at ewhpharmacy@hotmail.com, fax 604.498.0673 or call 604.356.1163.

NORTH VANCOUVER

MAPLE RIDGE

a pharmacist with the following qualifications: highly motivated and 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, a competitive wage and a benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resume to hr@nazwellness.com or fax 604.608.3230.

May/Jun 2016

We are looking for a pharmacist to join our growing company. We are an independent, community-based pharmacy providing patient-centered care. We require a pharmacist with the following qualifications: highly motivated and 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, a competitive wage and a benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resumes to hr@nazwellness.com or fax 604.608.3230. Pharmacist – full-time, part-time Permanent staff pharmacist needed in independent full-service community pharmacy. Position requisites include being: a registered pharmacist in good standing in BC; qualified, trained and experienced in PPP-66 and MMT; trained and qualified to administer

www.bcpharmacy.ca

Pharmacist – full-time, part-time

NORTHERN BC Pharmacist – full-time, relief Demonstrate strong sales ability, leadership, energy, passion and communication skills as we strive to be recognized as the Canadian leader in pharmacy health-care. Consult with patients to maximize Rx and OTC sales. Provide professional advice and applicable dialogue with patients on prescription and OTC products to provide excellent customer service. Be aware of any in-store events and support these events within the store. Supervise pharmacy technicians. Ensure company standard operating procedures, policies, professional standards and applicable laws and regulations are followed. Implement proper pricing and receiving procedures to minimize shrinkage. Maintain the dispensary inventory level within the prescribed guidelines through accurate perpetual inventory records. Please send resume to JAlati@rexall.ca, fax 1.877.781.6072 or call 780.341.4955. OSOYOOS Pharmacist – full-time We are looking for a motivated, team player who wants to be involved in all aspects of pharmacy practice and dispensary workflow. Someone who will excel in professional services, which are the present and future of pharmacy practice. Come and live steps from Canada's warmest lake, golf courses, water sports, wineries, orchards, skiing and all sorts of other activities. Our hours allow for the perfect balance between work and play. Our team believes in having fun at work while being highly productive and giving the best customer service possible. We include a RRSP plan, continuing education allowance, competitive wage, one of the best employee discount programs available and a yearly educational conference as some of the many benefits. Apply with your resume and references to asdm262@ shoppersdrugmart.ca or call 250.495.6055. PARKSVILLE Pharmacist – full-time Overwaitea Food Group, one of Western Canada's leading food and consumer-goods retailer, operates more than 110 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart 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! We have an opening for a pharmacist position at our store in Parksville, BC. Only shortlisted candidates will be contacted. Please send resume to Sammy Lee,

B.Sc. (Pharm), R.Ph., regional manager, pharmacy operations at sammy_lee@owfg.com.

SALMON ARM

PORT MCNEILL

Part-time staff pharmacist needed for two days per week in a busy pharmacy in downtown Salmon Arm. No evenings or Sunday shifts. Focus on pharmacy services and injection services is required. Previous compounding experience is preferred. Only those selected for an interview will be contacted. No phone calls please. Please send resume to Linda Gutenberg, director of pharmacy at lgutenberg@forewest.ca.

Pharmacist – full-time Looking for a pharmacist to work with a great team in a newly renovated, spacious pharmacy and dispensary. Please send resume to owner Ron Downey at rwdowney@telus.net. PRINCE GEORGE

Pharmacist – part-time

Pharmacy manager – full-time

SECHELT

Reporting to the regional pharmacy director, the pharmacy manager, long term care is responsible for managing the pharmacy operations according to company guidelines, professional standards, all applicable provincial and federal laws and regulations and the provision of patient-focused services. Responsible for maintaining a cohesive working relationship with the staff. Please send resume to JAlati@rexall.ca, fax 1.877.781.6072 or call 780.341.4955.

Pharmacy manager – full-time

Pharmacist – full-time

Reporting to the regional pharmacy director, the pharmacy manager is responsible for managing the pharmacy operations according to company guidelines, professional standards, all applicable provincial and federal laws and regulations and the provision of patient-focused services. Responsible for maintaining a cohesive working relationship with the staff. Relocation allowance offered. Please send resume to JAlati@rexall.ca, fax 1.877.781.6072 or call 780.341.4955.

Demonstrate strong sales ability, leadership, energy, passion and communication skills as we strive to be recognized as the Canadian leader in pharmacy health care. Consult with patients to maximize Rx and OTC sales. Provide professional advice and applicable dialogue with patients on prescription and OTC products to provide excellent customer service. Be aware of any in-store events and support these events within the store. Supervise pharmacy technicians. Ensure company standard operating procedures, policies, professional standards and applicable laws and regulations are followed. Implement proper pricing and receiving procedures to minimize shrinkage. Maintain the dispensary inventory level within the prescribed guidelines through accurate perpetual inventory records. Please send resume to JAlati@rexall.ca, fax 1.877.781.6072 or call 780.341.4955.

SURREY

Pharmacist – part-time

Pharmacy manager – full-time

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! Part-time, permanent (32-40 hrs/wk) pharmacist position available at 555 Central Street, Prince George, BC V2M 3C6. Starting rate is $47.20. Please send resume to Livia Chan, regional manager, pharmacy operations at livia_chan@owfg.com.

RICHMOND Pharmacist – full-time We are looking for a pharmacist to join our growing company. We are an independent, community-based pharmacy providing patient-centered care. We require a pharmacist with the following qualifications: highly motivated and 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, a competitive wage and a benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resume to hr@nazwellness.com or fax 604.608.3230.

Pharmacy manager – full-time We are looking for a pharmacist manager for our new pharmacy opening January 2016. We are an independent, community-based pharmacy providing patient-centered care. We require a pharmacist with the following qualifications: highly motivated and 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, a competitive wage and a benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resume to hr@ nazpharmacy.com or fax 604.608.3230.

Pharmacist – full-time We are looking for a pharmacist to join our growing company. We are an independent, community-based pharmacy providing patient-centered care. We require a pharmacist with the following qualifications: highly motivated and 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, a competitive wage and a benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resume to hr@nazwellness.com or fax 604.608.3230. Pharmacist – full-time, part-time Pharmacist wanted for independent 'full-service' community pharmacy. Requirements: registered pharmacist in 'good-standing' in BC, trained in PPP66, experienced in MMT, authorized to administer injections and fluent in English. Details: shift selection from 6am – 4pm on weekdays and 6am – 2pm on weekends for 356 days/year, experienced support

www.bcpharmacy.ca

staff and management team and consistent patients amidst friendly community. Benefits: paid annual vacations, employment contract guarantee and compensation between $40 - $45/hour, contingent on job performance. Send your cover letter and resume to operations manager Venus at ewhpharmacy@hotmail.com. TOFINO Pharmacist – full-time Pharmasave Tofino is hiring for a passionate and energetic full-time pharmacist to start in the spring of 2016. The successful candidate will be expected to learn and participate in all clinical programs in-store. BC pharmacy license, fluent English and certifications for methadone and injections are required. One to two years' experience in pharmacy would be an asset. Pharmasave Tofino is an integrative pharmacy in an idyllic coastal village. We are a dynamic and evolving health centre with a strong focus on patient care, natural medicines, wellness/weight loss, medication reviews and travel health. Find us at www.facebook. com/epicpharmacy or on Instagram @epicpharmacy. Please send resume to owner Laura at info@ epicpharmacy.ca, online at www.epicpharmacy.ca, fax 250.725.1249 or call 250.725.4949. VANCOUVER Pharmacy manager – full-time Viet Pharmacy Ltd. dba Fraser Neighborhood Pharmacy is seeking to hire a full-time director of pharmacy. Please send resumes to fnpharmacy@ gmail.com or fax 604.669.4308. Pharmacist – full-time We are looking for a pharmacist to join our growing company. We are an independent, community-based pharmacy providing patient-centered care. We require a pharmacist with the following qualifications: highly motivated and 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’ healthcare outcomes and various managed care initiatives. We offer stability, a competitive wage and a benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resumes to hr@nazwellness.com or fax 604.608.3230. Pharmacist – full-time We are looking for a pharmacist to join our growing company. We are an independent, community-based pharmacy providing patient-centered care. We require a pharmacist with the following qualifications: highly motivated and 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, a competitive wage, and a benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resume to hr@nazpharmacy.com or fax 604.608.3230. Pharmacist – full-time Full-time community pharmacist position in East Vancouver. Punjabi/Hindi speaking is an asset. Must be familiar with Kroll and have at least two years’ experience. Please send resume to pdhillon1@me.com. Pharmacist – full-time Macdonald Prescriptions Ltd is accepting applications for a full-time pharmacist or registered technician to manage our compounding lab. This is a great opportunity for the right person to join a team in a long-established and respected Vancouver, family-run

May/Jun 2016

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business. Please send resume to vince@macdonaldsrx.com.

Pharmacist – full-time

Pharmacist – full-time Full-time 'clinical' pharmacist position available, experienced in retail and residential home care 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. Please no phone calls. Please send resumes to ymm@yyoung.com or fax 604.630.1001. Pharmacist – full-time, part-time Part-time/full-time pharmacist position available for an independent pharmacy in Vancouver. No evenings, weekends or public holidays. Cantonese speaking skills an asset. Please email resume to ctpharm8@gmail. com. Pharmacist – part-time Part-time pharmacist position available, experienced in retail and residential home care 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. Please no phone calls. Please send resume to ymm@ yyoung.com or fax 604.630.1001. Pharmacist – part-time A growing independent new pharmacy specializing in patient-centered care. We do dispense methadone but are not your typical methadone pharmacy. Known for our outstandingly efficient operations and loyal patient population, we have created a great environment to work and thrive. Seeking a pharmacist who is highly motivated, with a strong work ethic, strong customer service skills, good communication and leadership skills, ability to work as a member of a dynamic and energetic team and, most importantly, willingness to actively participate in patients’ healthcare outcomes. Position is a permanent part-time leading to full-time. We offer stability, competitive pay structure and a great benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resume to drimrantejani@gmail.com. Pharmacist – part-time Part-time pharmacist position. Fluent in Mandarin and/ or Cantonese. Must be familiar with Applied Robotics, energetic and customer service-oriented. Please send resume to hytung@shaw.ca or call 778.997.6168. VERNON Pharmacist – part-time London Drugs has a part-time opportunity in Vernon. 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 resume to Shawn Sangha, pharmacy operations manager, at ssangha@ londondrugs.com. VICTORIA Pharmacy manager – full-time Reporting to the Regional Pharmacy Director, the Pharmacy Manager, Long Term Care is responsible for managing the pharmacy operations according to company guidelines, professional standards, all applicable provincial and federal laws and regulations, and the provision of patient-focused services. Responsible for maintaining a cohesive working relationship with the staff. Please send resume to JAlati@rexall.ca, fax 1.877.781.6072 or call 780.341.4955.

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May/Jun 2016

Pharmasave Hillside is looking for a full-time pharmacist to join our team. The successful applicant must have strong counselling and communication skills, a strong work ethic and be highly energetic. Experience with Kroll is a great asset. Injection and methadone certification are required. We are offering competitive wages and benefits. Please send resume to alf.ps142@gmail.com. Pharmacist – full-time, part-time, relief Attractive opportunity for full-time, part-time or relief pharmacists in Victoria. Excellent wages, health benefits, great hours in a friendly neighborhood pharmacy. Please send resume to har@sparklit.com or call 250.818.1468.

LOGAN LAKE – Pharmacy technician – full-time Send resume to Regan Ready, pharmacist/pharmacy operations manager at regan@teamrx.net, call 1.855.99.REGAN toll-free or email Dona at Ilida@telus.net. LOWER MAINLAND – Pharmacy technician – full-time - Please send resume to Aashyita.nanda@loblaw.ca. MAPLE RIDGE – Pharmacy technician – full-time Please send resume to hr@nazwellness.com or fax 604.608.3230. MAPLE RIDGE – Pharmacy technician – part-time - Please send resume to manager Narmin Khimji at narminkhimji@gmail.com or call 604.467.0753.

PHARMACY TECHNICIANS AND ASSISTANTS

MAPLE RIDGE – Pharmacy assistant – part-time Please send resume to alouettepharmacy@gmail.com or fax 604.467.3714.

For the full listings of pharmacy technician and assistant positions visit the Pharmacy Technician Society of BC website at ptsbc.ca

MASSET – Pharmacy technician – full-time - Please send resume to owner Alan Williamson at ps214@shaw.ca.

ABBOTSFORD – Pharmacy assistant – full-time, parttime - Please send resume to info@pharmasaveabby. com.

MCBRIDE – Pharmacy technician – full-time - Send resume to Regan Ready, pharmacist/pharmacy operations manager at regan@teamrx.net, call 1.855.99.REGAN toll-free or email Dona at Ilida@telus.net

BARRIERE – Pharmacy technician – full-time - Send resume to Regan Ready, pharmacist/pharmacy operations manager, at regan@teamrx.net, call 1.855.99.REGAN toll-free or email Dona at Ilida@telus.net.

MIDWAY – Pharmacy technician – part-time - Please send resume to Cris Bennett, pharmacy manager/ owner at boundarypharmacy@gmail.com, fax 250.449.2867 or call 250.449.2866.

BURNABY – Pharmacy assistant – full-time - Please send resume to pharmacyemployment@owfg.com.

MISSION – Pharmacy technician – full-time - Please send resume to Ellie Rahmani, pharmacy regional director for BC at Erahmani@rexall.ca.

CRANBROOK – Pharmacy technician – full-time Please send resume to peoplespharmacy@telus.net, fax 250.420.4135 or call 250.420.4133. DEASE LAKE – Pharmacy technician – full-time Please send resume to owner Alan Williamson at ps214@shaw.ca. DELTA – Pharmacy assistant – full-time - Kindly forward your resume and cover letter to shafik@ wescanapharmacy.com. GOLD RIVER – Pharmacy technician – part-time Please send resume to owner Colleen at collhogg@ hotmail.com, fax 250.285.3375 or call 250.285.2275. HUDSON HOPE – Pharmacy technician – full-time - Please send resume to owner Alan Williamson at ps214@shaw.ca. KAMLOOPS – Pharmacy technician – full-time - Please send resume to Missagh Manshadi, owner/pharmacist, at missagh@manshadipharmacy.com, online at www. manshadipharmacy.com, fax 250.434.2527 or call 250.574.0111. KELOWNA – Pharmacy technician – full-time - Please send brief cover letter and resume detailing previous pharmacy experience to Merrie-Jean.Mulhern@ remedysrxsp.ca. KIMBERLEY – Pharmacy technician – full-time Please send resume to owners Michelle and Andy Gray at accounting@grayspharmacy.ca or online at www. remedys.ca, fax 250.427.0039 or call 250.427.0038. LANGLEY – Pharmacy technician – full-time, parttime - Please send resume to frasermedicinecentre@ outlook.com, fax 604.530.8843 or call 604.530.8810. LANGLEY – Pharmacy assistant – part-time - Please send your resume to pharmacymgr@otter-coop.com or fax 604.856.3101.

www.bcpharmacy.ca

NANAIMO – Pharmacy technician – full-time, parttime - Please send resume to Kevin Cox, pharmacist/ manager at phr01525@loblaw.ca, fax 250.390.5732 or call 250.390.5730. NANAIMO – Pharmacy technician – full-time - Please send resume to Maria De Bruyns, pharmacy manager at rx267@forewest.ca, fax 260.755.1832 or call 250.755.1830. NEW AIYANSH – Pharmacy technician – full-time - Please send resume to owner Alan Williamson at ps214alan@shaw.ca or call 604.926.5331. NEW WESTMINSTER – Pharmacy technician – part-time - Please send resume and references to Pharmacy.ps275@shaw.ca or fax 604.525.5608. NORTH VANCOUVER – Pharmacy technician – fulltime - Please send resume to Pharmtechjob2015@ gmail.com. NORTH VANCOUVER – Pharmacy technician – fulltime - Please send resumes to hr@nazwellness.com or fax 604.608.3230. NORTH VANCOUVER – Pharmacy technician – parttime - Please email your resume and cover letter to azita_1@homail.com. PORT COQUITLAM – Pharmacy assistant – part-time Forward your resume, availability and wage expectations to ps190job@telus.net. RICHMOND – Pharmacy technician – full-time Please send resumes to hr@nazwellness.com or fax 604.608.3230. RICHMOND – Pharmacy assistant – full-time - Please send resume to mvirk_@hotmail.com. SICAMOUS – Pharmacy technician – full-time - Send resume to Regan Ready, pharmacist/pharmacy

operations manager at regan@teamrx.net, call 1.855.99.REGAN toll-free or email Dona at Ilida@telus.net. SURREY – Pharmacy technician – full-time - Please send resume to hr@nazwellness.com. VALEMOUNT – Pharmacy technician – full-time Send resume to Regan Ready, pharmacist/pharmacy operations manager at regan@teamrx.net, call 1.855.99.REGAN toll-free or email Dona at Ilida@telus.net. VANCOUVER – Pharmacy technician – full-time, parttime - Please send resume to ymm@yyoung.com or fax 604.630.1001. VANCOUVER – Pharmacy technician – full-time Please send resume to hr@nazwellness.com or fax 604.608.3230.

Coopers Foods, Overwaitea Foods, PriceSmart Foods and Urban Fare. With over 115 pharmacies in over 50 communities across BC and Alberta, and growing into Saskatchewan and Manitoba, our pharmacy team members share a passion for healthy living and quality, patient-centered care. We offer an attractive compensation package and our extensive benefits package is one of the industries finest. We have positions available in Parksville, Prince George, Quesnel, Grand Forks, Fernie, Fort Nelson, Prince Rupert and Campbell River. Please send resume to pharmacyemployment@owfg.com. Pharmacy technician - full-time Please call 604.444.9344, fax 425.427.7735 or email your resume to etoth@costco.com.

OPPORTUNITIES OUTSIDE BC

VANCOUVER – Pharmacy technician – part-time Please send resume to vince@macdonaldsrx.com.

ALBERTA

VANCOUVER – Pharmacy technician – part-time Please send resume to vince@macdonaldsrx.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 resume to pharmacyemployment@ owfg.com.

VANCOUVER – Pharmacy assistant – full-time, parttime - Please submit your resume with email address and phone number to mjsrxmanager@gmail.com. VANCOUVER – Pharmacy assistant – parttime - Please send resume to manager Jeff at albertopharmacy@gmail.com. VICTORIA – Pharmacy technician – full-time - Please send resume to jobs@victoriapharmacy.com. VICTORIA – Pharmacy assistant – full-time, part-time - Please send resume to clinic manager Irene HaighGidora at ihgidora@coolaid.org or fax 250.383.5933 or call 250.385.8469. VICTORIA – Pharmacy assistant – full-time - Please send resume to pharmacyemployment@owfg.com. VICTORIA – Pharmacy assistant – full-time - Please email your resume and cover letter to pharmacy manager Blaine Wilkins at callmeblaine@gmail.com or call 250.388.5051. WHITE ROCK/SOUTH SURREY – Pharmacy assistant – full-time - Please email your resume and cover letter to MyPharmasave@telus.net.

Pharmacist – full-time

Pharmacy assistant – part-time Please send resume to pharmacyemployment@owfg. com. GRAND PRAIRIE, AB Pharmacy assistant – part-time Please send resume to pharmacyemployment@owfg. com. MANITOBA Pharmacist – full-time

OPPORTUNITIES ACROSS BC Pharmacist – full-time, relief Demonstrate strong sales ability, leadership, energy, passion and communication skills as we strive to be recognized as the Canadian leader in pharmacy health care. Consult with patients to maximize Rx and OTC sales. Provide professional advice and applicable dialogue with patients on prescription and OTC products to provide excellent customer service. Be aware of any in-store events and support these events within the store. Supervise pharmacy technicians. Ensure company standard operating procedures, policies, professional standards and applicable laws and regulations are followed. Implement proper pricing and receiving procedures to minimize shrinkage. Maintain the dispensary inventory level within the prescribed guidelines through accurate perpetual inventory records. Please send resumes to JAlati@rexall.ca, fax 1.877.781.6072 or call 780.341.4955. Pharmacist – part-time Advance your pharmacy career with the Overwaitea Food Group, a Canadian-owned company that operates under multiple banners: Save-On-Foods,

Advance your pharmacy career with Save-On-Foods. With over 100+ pharmacies in over 50+ communities across BC and Alberta, and growing in Saskatchewan and Manitoba, our pharmacy team members share a passion for healthy living and quality, patient-centered care. Our pharmacy team members are made up of hardworking people who thrive in a demanding and changing environment and are deeply committed to their patients. We offer: friendly, professional and supportive work environments; flexibility, stability and great compensation packages; opportunities to develop your leadership skills, expand your scope of practice and advance your career. Pharmacist positions available in: Winnipeg, Manitoba. Please send resume to Livia Chan, regional manager, pharmacy operations at livia_chan@owfg.com. SASKATCHEWAN Pharmacist – full-time Advance your pharmacy career with Save-On-Foods. With over 100+ pharmacies in over 50+ communities across BC and Alberta, and growing in Saskatchewan and Manitoba, our pharmacy team members share a passion for healthy living and quality patient-centered care. Our pharmacy team members are made up of

www.bcpharmacy.ca

hardworking people who thrive in a demanding and changing environment and are deeply committed to their patients. We offer: friendly, professional and supportive work environments; flexibility, stability and great compensation packages; opportunities to develop your leadership skills, expand your scope of practice and advance your career. Pharmacist positions available in Regina & Yorkton. Please send resume to Livia Chan, regional manager, pharmacy operations at livia_chan@owfg.com.

BUSINESS OPPORTUNITIES Are you thinking of selling your pharmacy? Overwaitea Food Group may be interested. If you would like more information please contact pharmacybuyer1@gmail.com. Forewest Holdings partners with local pharmacists and currently owns 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 Don Fraser, CEO and president, at dfraser@ forewest.ca or call 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, contact Frank Cucca toll free 1.877.450.6006, ext 18 or 604.619.4846 or frankc@pdmstores.com. ABBOTSFORD - pharmacy for sale/partnership A pharmacy is seeking a partner or an Arabic speaking pharmacist to take over. The average Rx count was 24/day in 2015 and is now 52/day now. Asking price is 300K. Thank you and good luck. Please email ipg_r.ph@hotmail.com. KAMLOOPS – pharmacy for sale Owner moving out. Well-established business with growth opportunity for a young business oriented pharmacist(s). Contact pharmasaveforsale@gmail. com. VANCOUVER – pharmacy manager and business partnership opportunity Private pharmacy in Vancouver looking for an enthusiastic and experienced pharmacist to become a business partner and work as the pharmacy manager. The candidate must be energetic, friendly, patientfocused, capable of enhancing operational efficiency and business value and have the ability to manage day-to-day pharmacy operations independently. Also, they must comply with the provincial/federal pharmaceutical regulations at all times. A minimum of two years of experience in retail pharmacy, preferably as a pharmacy manager, is required. Please email your resume and a letter explaining why you think you would be ideal for this opportunity to pharmacy1601@ gmail.com. Only qualified applicants will be contacted.

May/Jun 2016

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Join us May 26 to 28 in Kelowna, BC at the Delta Grand Okanagan Visit www.bcpharmacy.ca/conference to learn more and register!

Partner

Thank you to our sponsors: Diamond

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pharmacy

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Exhibitors: Adams Cambie Insurance Services Ltd., College of Pharmacists of British Columbia, CWB Maxium Financial, Green Shield Canada, Ideal Protein, InnoviCares, JAMP Pharma, Johnstones Benefits, Kohl and Frisch, Lifescan, McKesson Canada Automation, Merck, Pacific Blue Cross, PCCA, PENDOPHARM, Pfizer Canada Inc., Roxon medi-tech, Scotiabank, Sanofi Pasteur, Stallergenes, Thorne Research, Tom Harris Cellular, Valeant Canada, Wynward Insurance Group, Xenex Laboratories Inc.