National pharmacy group skeptical of Nunavut scheme

If you have a question about medications you take or want to get a prescription filled, you can go directly to Brooke Fulmer, the pharmacist in Cambridge Bay’s Kitnuna Pharmacy. The combination of face-to-face contact and expertise is what makes local pharmacists so valuable, says the director of the Canadian Pharmacists Association. (PHOTO BY JANE GEORGE)

Nunavut’s plan to bypass community pharmacists in favour of less qualified pharmacy technicians and a remote pharmacist in Ottawa puzzles the executive director of the Ottawa-based Canadian Pharmacists Association.

“You have a situation where you do have some expertise locally, but you’re choosing not to use it, and that would seem to be a waste of resources and not good local policy,” Jeff Poston, also a doctor of pharmacology, told Nunatsiaq News in a March 7 interview.

Most Canadian jurisdictions are now looking in the other direction with respect to their pharmacy services, he said — at ways to bolster their community pharmacists’ responsibility and to keep their local pharmacies open.

Some provinces in Canada are passing legislation to dramatically expand the scope of practice for pharmacists so they can prescribe certain medications, he said.

And in remote areas of Ontario and Alberta, community pharmacies get more government support to help them survive financially, he said.

Most areas are trying to help their local pharmacies stay open, because in many places it’s easier to keep a pharmacist in a town than a physician.

Nunavut’s plan to foster tele-pharmacy should be used when you don’t have or can’t keep local pharmacists, Poston said.

“It seems odd that the government would not want to support the development of this, and would adopt policies that would undermine that local community infrastructure,” he said.

“I think there’s a value to having a pharmacy in the community which the government is missing.”

There are many advantages to local community pharmacists, and “no substitute for the face-to-face interaction between the pharmacist and the patient.”

Pharmacists can deal directly with patients — something that would be even more important in Nunavut where language issues may come into platy, Poston suggested.

“Community pharmacists in these settings do a lot more than just distribute drugs,” he said.

They know the community, the people and the lifestyle— and they can also serve as a first line of medical treatment, referring a client on to a doctor when symptoms seem acute and in need of treatment.

But the pharmacist remains the drug expert for medical professionals, he said.

“They have five years university training, devoted to drugs and drug therapy, whereas the average nurse, physician get a fraction of that. Pharmacists have vastly more knowledge about drugs,” Poston said.

As for tele-pharmacy, there’s no model of this kind of service used anywhere else in Canada, except on a pilot basis, he said.

Instead, Nunavut could empower local community pharmacists in Iqaluit, Rankin Inlet and Cambridge Bay, and allow them to receive more expertise from a clinical expert, if they need it, through a drug information service, similar to one that operates in Ontario.

Poston’s parting advice is for Nunavut to carry out more consultation before changing over to its new pharmacy scheme.