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TORONTO — Canada's Premiers gathered in Charlottetown for the latest Council of the Federation meeting starting on Aug. 26, and health reform is a key topic. The pharmacy community is urging provinces to consider further expanding pharmacists' role as they can make important contributions to improving patient outcomes, reducing costs and ensuring the sustainability of the health care system.
According to a new report from Shoppers Drug Mart and CARP, the Sustainable Solutions Report: A Focus on Pharmacist Medication Reviews, one way to make real change now is for governments to support improved access to medication reviews.
These one-on-one medication reviews with a pharmacist can help individuals gain a better understanding of their medications and avoid potential health risks, Shoppers Drug Mart stated. These are particularly important since many aging adults are on multiple medications at once for various conditions — e.g., a new poll of CARP members found one-third are currently taking four to five medications. Numerous medications can increase the risk of drug therapy problems like adverse drug reactions, negative drug interactions, improper dosing and medication adherence issues.
"This new report includes data demonstrating both the public and medical professionals see the value in pharmacists conducting medication reviews," stated Domenic Pilla, president, Shoppers Drug Mart. "Most of our provincial governments have begun to recognize the benefits and have instituted funding for this important pharmacy service. We now have the opportunity to make the eligibility requirements and funding for this service more consistent across the entire country to improve patient care and safety."
The pharmacy community is calling on provincial governments to take a comprehensive and universal approach to the provision of medication reviews. Where medication reviews are funded, which is 8-out-of-10 provinces, there are significant inconsistencies in the eligibility requirements necessary to have the consultation covered. And, many individuals may not take advantage of medication reviews because of a low awareness of their availability.
Why are Medication Reviews Important? These reviews provide the opportunity to identify and prevent drug therapy problems, including ADRs and medication non-adherence issues. A recent survey of Canadian family physicians found more than three quarters of them (79%) believe expanding the role of pharmacists (including offering services like medication reviews) will have an impact on reducing the incidence of ADRs. This is significant since cases of drug therapy problems are likely to increase as our population ages and more are faced with managing multiple chronic illnesses with numerous therapies. Today, approximately 5% of all emergency room visits and 6% of all hospital stays are the result of ADRs. And, medication non-adherence results in an annual cost of Canadian $7 billion to $9 billion to the health care system, and 125,000 unnecessary deaths per year, Shoppers Drug Mart stated.
Where medication reviews are funded, steps need to be taken to establish comprehensive and consistent eligibility criteria since they currently vary greatly by region, the company stated. For example, Alberta has one of the most comprehensive medication reviews programs — patients must have at least one chronic medical condition from a pre-defined list and be taking three or more prescription medications. In contrast, British Columbia patients need to be taking five different qualifying medications, but may have two reviews per year. Seniors from New Brunswick and PEI taking three or more prescription medications for chronic conditions are eligible for one medication review per year whereas, seniors from Saskatchewan must be taking five or more chronic disease medications to be eligible. The Ontario program is available to any Ontarian taking three or more prescription medications for chronic conditions, and it also offers different assessments based on patient needs (e.g., at-home consultation, diabetes patients, etc.).
And finally, where medication reviews are available, there needs to be a greater emphasis on promoting the service. Getting the word out will require a joint effort between government, pharmacists and other health care professionals who can refer the service, according to Shoppers Drug Mart. A new survey of individuals from British Columbia, Alberta and Ontario who recently completed a medication review found the majority (84%) said they heard about the medication review from their pharmacist.
The good news, noted Shoppers Drug Mart, is the same survey found people had an extremely positive experience and would recommend it to others. One-in-two surveyed strongly agreed medication reviews are beneficial and the majority (85%) were likely to make medication reviews a regular part of managing their medications and their health. A further 79% said they would recommend medication reviews to others they know who also take prescription medications.