JANUARY 2021 – As we approach a full year of pandemic living in Canada, the past months have shown us where the gaps and wins in pharmacy are happening so far. At the Canadian Foundation for Pharmacy’s annual Pharmacy Forum, held virtually in November, presenters focused on how COVID-19 has served as a catalyst with a positive impact on pharmacy services—and what needs to be done for the profession to thrive in the future.
Drawing on the theme of “COVID-19: Accelerating the Pace of Change,” presenters provided national and provincial perspectives on pharmacy’s response to the crisis so far, including how COVID-19 has unearthed some unexpected boosts for the expanded role of pharmacists in areas like opioid stewardship and testing for infectious disease.
For example, prior to the pandemic, the Canadian Pharmacists Association (CPhA) had determined that advocating for the pharmacist’s role in opioid stewardship would be a priority in 2020, with a focus on harmonizing authorities across provinces and territories. “And then serendipitously Health Canada’s Section 56 exemptions came on board,” said Dr. Shelita Dattani, Director, Professional Development and Knowledge Translation at CPhA. These exemptions to the Controlled Drugs and Substances Act give pharmacists added authorities until September 2021, setting the stage for pharmacists to demonstrate how they can build capacity in the care of these vulnerable patients.
Similarly, COVID-19 testing in Alberta and Ontario has helped set the stage for pharmacies to play an ongoing role in point-of-care testing for infectious disease. In Alberta, Margaret Wing, CEO of the Alberta Pharmacists’ Association, shared that pharmacists had conducted more than 175,000 tests during the four months of its program for asymptomatic individuals (from late June to late October). Almost half of the province’s pharmacies (45%) had signed on to participate in the voluntary program.
Evolving practice models
Another positive for the profession has been the willingness of pharmacists across the country to step in to assist patients with all their health needs when their physicians couldn’t. “Pharmacists started doing things differently and thinking outside the box,” says Smita Patil, Senior Director, Industry Affairs, Communications and Public Affairs at McKesson Canada. She points to a “moment of realization” among independent pharmacies in recognizing that they could still communicate with patients virtually or by telephone—especially as doctor’s offices were closed and chronic disease patients were falling through the cracks.
Now that patients have grown more accustomed to virtual care, she says pharmacies—especially those with a smaller footprint who haven’t jumped into virtual care yet—should be thinking about how to adapt to that mode of care post-pandemic. “People are going to expect to be able to interact in different ways,” she said, noting that stakeholders will need to do their part in helping set up pharmacies for success. “When we’re not prepared, patients don’t have the confidence we can do it.”
Fault lines and future opportunities
While pharmacy is a key part of the healthcare strategy to survive these unprecedented times, Ontario Pharmacist Association’s CEO Justin Bates said the pandemic has also exposed “fault lines” between the business and the profession that need attention. “It’s about how do we bridge that to ensure we have a workplace that is good for the pharmacy professional,” he said. “We’re seeing COVID fatigue for frontline providers in dealing with expanded scope at a time when reimbursement is not always in line.”
On the topic of personal resilience, Dr. Zubin Austin, Professor at the Leslie Dan Faculty of Pharmacy, University of Toronto, shared results from “COVID-19: How did community pharmacies get through the first wave?” The qualitative research uncovered six main factors in the workplace that support personal resilience, based on interviews of pharmacy staff from March to May 2020.
On the positive side, the pandemic “has changed our relationship with government and put us more into the consciousness of the public,” stressed Bates. “We have made significant progress that will pay dividends when it comes to the realities we will face [post-pandemic].”
He added: “I firmly believe that the lanes of healthcare are converging, and it is about an integrated model and how we can step up with all healthcare providers to meet the needs of the patient.”
To that end, frontline pharmacist/owner Darren Erickson of Guardian Drugs in Tofield, AB, spoke to his desire to continue those temporary services implemented during COVID-19 (e.g., virtual medication reviews, narcotic authorization, appointment-based services, testing, etc.), on a long-term basis. “COVID has accelerated so much of what we’re doing in pharmacy and increased our relationship touch points with patients and that’s a very good thing,” he said. “Patients are so much aware of what we do, and people really don’t have time to go to the hospital and wait for some of these services.”