The Canadian Foundation for Pharmacy’s recent Innovation Showcase provided attendees with some insights on the challenges in fixing Canada’s healthcare system, plus updates on CFP-funded projects around warfarin therapy, medical cannabis and tools to improve medication reviews.
Jeffrey Simpson, journalist and former national affairs columnist for The Globe and Mail, kicked off the evening event by speaking to healthcare system concerns, such as the lack of timely access to services, and an aging population which will inevitably translate to higher healthcare costs ahead. “It doesn’t seem to matter how much governments put into a system, they always seem to be playing catchup,” he said.
He referenced international data that showed Canada’s wait times—for services and for securing a family physician—was the worst among all the western countries. In the meantime, he said providers in the system (including pharmacists) are unhappy with pay or working conditions or are generally feeling underappreciated.
In referencing pharmacare as a solution to escalating drug costs and lack of access, Simpson advised that there were still many more questions and debates to be had. In addition to the “billions of dollars needed” to replace private drug plans and expand public ones, he said there was still no way of knowing if a pharmacare path would be less costly than what currently exists. “Although [pharmacare] could be more fair, and overall a social good,” he added.
Simpson also stressed the fact that 82% of medications currently on drug formularies are the same, yet each province negotiates separately on behalf of taxpayers. “Provinces should be collectively negotiating to use their purchasing power to bring prices down,” he said. “What we’re doing at the moment seems to be very counterproductive.”
Attendees also heard research updates from Innovation Fund recipients Joey Champigny, Beth Sproule and Karen Riley.
Working with pharmacist Jeff Nagge, Champigny is aiming to prove the value of community pharmacist-managed warfarin therapy in lowering risk of stroke, systemic embolization, venous thromboembolism and hemorrhage. “Our aim with this project is to compare not only the efficacy of pharmacist-managed warfarin therapy but the safety in doing so…and to show that it should be the gold standard,” he said. Working in anticoagulation himself, he said he was excited to join Nagge in helping raise awareness around all the good things pharmacists can do in managing warfarin therapy.
Given the growing use of cannabis among Canadians of all demographics, Sproule and her team developed a clinical guide for providing care to patients using cannabis, and then tested it among four community pharmacists over three months. The participating pharmacists said the guide helped boost their confidence in speaking about cannabis and its potential interactions with other medications. “They noted that patients too appreciated getting non-biased information about cannabis,” said Sproule. But time and resources in providing this care were also key considerations too. One participating pharmacist noted that “…this type of tool would thrive pretty well once vaccines start to slow down or in settings where there are multiple pharmacists on board and one can be focused on providing these sorts of clinical services.”
Next up, Sproule says her team is exploring the feasibility of developing a version of the guide that could be integrated into an electronic health record.
In exploring the impact of clinical decision support systems (CDSS) on medication reviews, Riley and her team uncovered favorable results. “Our findings provide initial support for the use of CDSS in facilitating effective medication reviews, particularly, for older adults,” she said. Not only did pharmacists find the QRM tool used during the pilot easy to use, the study showed an increase in the number of patient medication reviews that resulted in pharmacist recommendations sent to primary care physicians.