Thousands of prescription medications now exist. Pharmacists need to be familiar with all of them. They must also understand the effects of over-the-counter (OTC) drugs, vitamins, herbals and natural products.
Pharmacists are an integral part of the process started by the physician to ensure the right patient is getting the right medication, in the right strength, in the right way. To do so, they must be familiar with standards of treatment for many conditions, such as diabetes, asthma, and infections. Anticipating possible interactions between drugs, foods, and medical conditions is necessary. As part of your health care team, your pharmacist will also monitor the wide range of medications you may take or have prescribed for you.
The most recent pharmacy graduates in Canada have at least five years of university education that includes extensive on-the-job training. Of course, experience also counts!
New and different prescription and non-prescription drugs become available each year. As the number of drugs increases, so does the pharmacist’s need to continue education past university. To keep their licenses up-to-date and valid, practicing pharmacists must complete a certain number of education credit hours each year.
Pharmacist Rosalie Bader has been witnessing changes within the pharmacy industry for 40 years.
“The focus has changed from a type of work based on a business to a profession that is more focused on patient care,” Rosalie says.
The biggest change Rosalie has seen involves technology. For instance, computerization has brought many positive changes. Computer programs now allow pharmacies to keep detailed electronic patient records. Personal information, such as allergies, birth dates, and health care numbers, can be easily accessed. Records of current medications and those taken in the past are also on file.
Some provinces are developing or already have provincial computer programs in place. Such systems allow pharmacists to get a more complete look at a patient’s drug profile. They are based on information sent to provincial drug plans when a prescription is filled.
This information can help people in many ways. For instance, you might become sick while traveling within your home province. With a provincial computer program, you can take your prescription to any pharmacy. Staff there can access the system for a list of your regular medication and any possible drug interactions.
These programs are also available in hospitals. Such a system is particularly useful when unconscious patients arrive in emergency. Although patients may be unable to communicate, information on health and medication history can be used to help them.
Students graduating with a degree in pharmacy have more than one choice of employment. Most of us commonly think of a community pharmacist, who serves the public in a drug, grocery or department store.
However, pharmacists can work in many places. They can work in research labs, testing and developing new drugs or finding new uses for old drugs. Jobs are available in hospitals, cancer clinics and long-term care facilities. Other possibilities include drug and insurance companies, or regional or national boards representing pharmacists. Some pharmacists continue their education so that they can teach future pharmacists.
Community pharmacy itself is changing. More pharmacists are specializing in certain areas of pharmacy practice to provide a different level of patient care. Pharmacists can take many self-study courses and exams to become certified educators in medications and the treatment approaches used in certain disease conditions. Diabetes, asthma, menopause, stop-smoking programs, and geriatric care are a few examples. Such programs allow pharmacies and pharmacists to help patients manage their disease more effectively.
Pat Smith, a pharmacist in Regina, has been practising for 34 years. She is a certified asthma and COPD (chronic obstructive pulmonary disease) educator. Pat educates patients, fellow pharmacists, other healthcare professionals and students about asthma and COPD, and how to manage and treat these conditions.
Throughout the centuries, pharmacists have compounded (made or mixed together) medicines for their patients. In fact, until the early 1900s, the only medications available were compounded. However, once drug manufacturing companies started making standardized drugs and dosage forms, pharmacists were asked to compound fewer medications. That doesn’t mean compounding has vanished from the practice of pharmacy!
Compounding is still alive and well. Although big drug manufacturers still supply most medicines, some pharmacists have returned to their roots and become compounding experts.
Compounding allows the physician and pharmacist to customize patient medications. Different strengths, flavors or dosage forms of medications may be needed from those commonly available.
Children and infants may need tablets or capsules made into a liquid that is easily swallowed and tastes good. Those who have difficulty swallowing or experience side effects when they take drugs by mouth may be able to use another form, such as a suppository or a gel absorbed through the skin.
Sometimes drug manufacturers are temporarily unable to supply a medication. Compounding can often duplicate the drug until it becomes available again.
If a drug is discontinued, compounding may be the only way to supply the medication for patients who need it. New or alternative therapies are often first available to doctors and patients only through compounding pharmacists.
Compounding pharmacists often have advanced training in areas such as dermatology, bio-identical (natural) hormone replacement therapy, veterinary medicine and pain management. They have learned to make creams and lotions, lozenges, suppositories, liquids, transdermal gels, capsules, gummies, lip balms, sublingual (under the tongue) tablets and drops, medicated animal treats and more.
Ask your pharmacist if compounded medication may be the right choice for you!
As an asthma educator, Pat often holds clinics in doctor’s offices to help patients learn to control their asthma or COPD. These clinics also help patients understand why they take medication and how to use it properly. Pat will often collaborate with doctors about drug therapy for certain patients.
In the future, Pat says that we should expect more specialization. A health team approach will be used to treat patients. As new drugs and advances in treating disease become available, health care providers will need to continually improve their knowledge. More interaction among all health professions will be necessary to provide good patient care. Pharmacists will have to be comfortable managing medication outside of a traditional pharmacy.
Pharmacists can specialize in many ways. Those working in other areas of the community will be able to effectively use their skills and knowledge to make a difference in people’s lives. Of course, the need for community pharmacies will never fade away, but these professionals may have different responsibilities in the future.
Pharmacy technicians now work in most pharmacies. They are a big part of the changing role of the pharmacist. The work a technician does allows pharmacists to spend more time with clients and to ensure the right medication in the right dose is reaching the right patient.
Technicians enter prescription or demographic information into the computer and count medications. However, the pharmacist is responsible for doing a final check.
Technicians also help take inventory and place orders. Some are trained in the use of blood glucose meters and blood pressure monitors. They help patients pick out the machine best suited to them, and teach the technical aspects of using it.
Technicians are one main reason why more pharmacists can get out from behind the counter to discuss individual concerns with their customers and provide more education about managing chronic conditions.
In Canada medications are classified in several groups. Those classified as schedule 1 medications can only be prescribed by a physician following consultation and examination leading to a diagnosis of a patient’s medical problem. Recently, there have been some changes to this involving pharmacists. All over Canada, many pharmacists already have the responsibility for prescribing Plan B, also known as the morning-after pill or emergency contraceptive. In many provinces, a woman can go straight to the pharmacy to get Plan B without a prescription from a doctor. However, the pharmacist must talk to women about the medication to be sure that it is the right therapy for them.
Across the country, physicians and pharmacists are working together to ensure patients get the best possible care. With this objective in mind, pharmacists in Alberta are now able to prescribe certain prescription medications after a diagnosis or decision for treatment has been made by a doctor. For instance, patients would no longer have to see a doctor each time a refill is needed. Pharmacists may make the decision whether to prescribe a refill or to refer the patient back to the doctor. Pharmacists may also adapt prescriptions for some medications patients already take and notify the prescribing doctor afterwards.
In some emergencies pharmacists may prescribe a small amount of a drug to treat symptoms until a physician can be seen for proper examination and diagnosis.
New graduates of the University of Alberta have the training they need to offer certain prescriptions. Practicing pharmacists will have the chance to become certified. These changes to the health care system give pharmacists more responsibility as partners in your health care.
Pharmacists are respected sources of information for the public. Thanks to community pharmacies, you can easily ask these professionals about medications, chronic diseases or minor illnesses. Pharmacists also do more questioning than in the past when talking to patients about new prescriptions or helping to choose an over-the-counter product. Pharmacists have learned that asking questions allows them to get the information needed to ensure their medication is appropriate.
Pharmacists today can help with a range of concerns from quitting smoking to managing high blood pressure, diabetes and many others. They have access to many resources. Although the Internet has increased awareness about health conditions, it is not always the best source of information. Anyone can publish a website and some are not factually accurate. It is often difficult to decide if sites actually have correct information or whether they are just selling something. Your pharmacist can help you differentiate between the two as well as answer other related questions that may arise.
Recent trends suggest pharmacists will have more responsibility in the future. As pharmacists become more involved with patient care and specialize in certain areas, patients will definitely start to see changes. Along with doctors, nurses and other professionals, pharmacists will remain an essential part of your health care team.