The Tablet - June/July 2014

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BCPhA Conference Highlights • Bupropion Toxicity • Renal Pharmacy Myth Busting

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published by the British Columbia Pharmacy Association | www.bcpharmacy.ca | Volume 23. No. 3

2014 BCPhA Pharmacy Awards

JUN/JUL 2014


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THE TABLET

JUN/JUL 2014  |   VOLUME 23. NO. 3

contents Editor-in-Chief Kathie Taylor 604.269.2863, kathie.taylor@bcpharmacy.ca Senior Editor Elise Riedlinger 604.269.2866, elise.riedlinger@bcpharmacy.ca Advertising Sales Shannon Ward, OnTrack Media 604.639.7763, tablet@ontrackco.com

5 Up Close

The Tablet is published by the BCPhA. Views expressed herein do not necessarily reflect those of the Association. Contributed material is not guaranteed space and may be edited for brevity, clarity and content. BCPhA offices: #1530-1200 West 73rd Avenue Vancouver, BC  V6P 6G5 telephone: 604.261.2092 or toll-free in bc: 1.800.663.2840 fax: 604.261.2097 toll-free fax: 1.877.672.2211 e-mail: info@bcpharmacy.ca web: www.bcpharmacy.ca Pharmassist: 1.800.667.2190 For confidential counselling referral for employment or addiction related assistance

16 Conference 2014

19 Pharmacy Awards

Publication agreement #40810576

On the cover: Ken Foreman (right) was the recipient of the 2014 Lifetime Achievement Award, presented by BCPhA president Don Cocar.

Features

Columns

Regulars

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Up Close Ken Foreman

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President’s Message Recap on conference

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DPIC Focus on bupropion toxicity and abuse

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BCPhA Annual Conference 2014

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CEO’s Message Making it happen

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Pharmacy Practice Support New frontiers for pharmacy

Clinicare Pharmacists The quick and easy on urinary incontinence

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Member Services Professional judgment = risk exposure

Student News Be an agent of change

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Government Relations Push for pharmacy services goes on

Financial Trends Preparing the next generation for wealth

22

Renally Speaking Renal pharmacy myth busting

25

Career Listings Find a job in pharmacy

Highlights from Whistler

19

On the Cover:

BCPhA Pharmacy Awards

11

2014 recipients

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Pharmacy Profile: STSRx A space outside the dispensary

A voice for community pharmacy

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Got a suggestion for an article in The Tablet? Email info@bcpharmacy.ca with your story ideas.

www.bcpharmacy.ca

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SMALL TALK

In the news Frequency of Dispensing eTraining program The BCPhA's newest eTraining program, Frequency of Dispensing, is now available online. The Frequency of Dispensing program provides a brief review of PharmaCare and third party frequent dispensing policies and documentation requirements. This program is estimated at 0.5 nonaccredited learning hours and provided as a complimentary member benefit. Visit www.bcpharmacy.ca/eTraining for more details or to begin your eTraining.

BCPhA welcomes new coordinator, pharmacy practice support In May, the BCPhA welcomed Nelson Chen as the new coordinator of pharmacy practice support. Nelson is a pharmacy assistant who also works at two Shoppers Drug Mart locations in Vancouver and has six years of community pharmacy experience. He is currently in the process of completing the bridging program to become a regulated pharmacy technician.

Chronic Pain 101

Nelson’s role at the Association includes maintaining the Administration of Injections Program workshops and handling public and private payer inquiries.

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Community pharmacists are invited to join Pain BC for a CCCEP accredited (9.0 CEUs) education program in Chronic Pain Management, supplemented with one-to-one mentoring on clinical pain consultations.

www.bcpharmacy.ca

Sessions will be held in locations across BC this fall, including Nelson, Kelowna, Courtenay, Nanaimo, Kamloops and Maple Ridge. For more information or to register, visit www.bcpharmacy.ca/industry-eventsand-notices.


UP CLOSE

Up close… with Ken Foreman By Elise Riedlinger

Although Ken Foreman’s career officially started in 1976 when he graduated from the University of British Columbia’s Faculty of Pharmaceutical Sciences, you could say that pharmacy was in his DNA.

Growing up in his father’s pharmacy in Cloverdale, Ken knew early on that he wanted to follow in his dad’s footsteps, a well-respected member of the community who went out of his way to know all of his patients by name. “I’ve been in a pharmacy for as long as I can remember,” Ken said, “As a little kid, doing odd jobs here and there. I never had thoughts of doing anything else.”

He served terms as president of the College, the BCPhA and the Chain Drug Association of BC, and also held key roles on a number of Ministry of Health and BC Medical Association committees. And, over the three decades of his career, he’s witnessed – and been a critical part of – a huge transformation in pharmacy, from typewriters to e-prescribing and new clinical services such as injections and Medication Reviews. “PharmaNet is the biggest ground-breaking project that I’ve personally been involved with, because it was the first of its kind in North America,” he said, referring to his time in the mid-90s as chair of the College’s PharmaNet User Group.

He began his career as a community pharmacist in Vernon at a time when it was difficult for the graduating pharmacy class to find full-time work, and moved back to the coast in 1978 to become an associate-owner with Shoppers Drug Mart until 1995. Ken spent the next six years in management positions with Shoppers before becoming the BC Pharmacy Association’s director of professional services and deputy CEO. Then, in 2005, he joined Pharmasave as manager of pharmacy innovation, a position that later transitioned to manager of pharmacy, which he still holds today.

“For years, pharmacists had been saying that the missing piece of information was medications being dispensed at another pharmacy. PharmaNet closed the ends of that circle.”

His career seemed to come full circle when the Pharmasave office relocated to Cloverdale, choosing the former post office as its new home.

Ken has recently announced his retirement in August, and is looking forward to continuing his hobbies of golfing, boating, skiing and photography, and of course, spending time with his family. He and his wife Marcia will celebrate their 35th wedding anniversary this fall with a Mediterranean cruise.

“It’s a little ‘back to the future,’” he said. “My current office is where as a kid I used to trundle over to collect the mail for the pharmacy; it was one of the chores I had back then!” Beyond his daily work life, Ken also managed to play an extremely active role in the pharmacy profession through associations, volunteer work and committees. “I truly believe that for a profession to evolve, the members have to be involved,” he said. “I’ve been involved pretty much since day one coordinating CE events, which led to an opportunity with the BCPhA – known then as the BC Pharmacists Society – and from there working with the College of Pharmacists of BC.”

In recognition of his many accomplishments, Ken was recognized with this year’s Lifetime Achievement Award from the BCPhA. “I was very honoured to be chosen for this incredible award, and humbled by it,” he said. “I had a great mentor in my father, as a family man and a professional businessman.”

“And obviously, I’ll probably find some way to stay involved with the profession,” Ken said. “I’m not looking for another full-time job, but if something comes along where I can be of value, I’ll certainly do what I can to help. “It’s a fabulous profession and the sky is the limit as to where we can take it. But it’s going to take the involvement of members to move it forward – and really the future is in everyone’s hands. We’re so lucky that we can shape where our profession is going to go.” Learn more about Ken’s Lifetime Achievement Award and the other recipients of the 2014 BCPhA Pharmacy Awards on page 19. www.bcpharmacy.ca

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DON COCAR | PRESIDENT

Recap on conference

The BCPhA Annual Conference 2014 was a great success and I’m glad I had the opportunity to meet so many of our members in Whistler.

This year we saw our largest turnout in history – more than 320 people from across the province and beyond joined us during the three-day event! That included our two fantastic student volunteers and eight BCPhA Student Ambassadors, as well as an additional 21 students who really brought great energy and enthusiasm. They give me every confidence the future of our practice is going to embrace the innovation and technology needed to continue to move the profession forward. Also looking towards the pharmacy of tomorrow, Doug Stephens kicked off the conference sessions with his fascinating keynote address on The Future of Retail Pharmacy. Although he noted that some industry specialists predict brick and mortar stores will soon go the way of the dinosaur, Stephens brought a lot of optimism about the new online era. Social media can provide some opportunities for pharmacy businesses, but he reminded us that it’s actually the personal interactions with your customers and patients in-store that keeps them coming back. One thing that really stuck with me is something Stephens said about innovation and taking chances: if a new idea doesn’t scare you a little bit, it’s probably not very innovative. That made me think about pharmacy, and our expanding scope of practice. For example, back when we started giving injections, it may have made some of us nervous at first, but look at how quickly pharmacists – and patients – have embraced this service. In only five years since gaining the authority to inject, we’ve gone from zero to an estimated 360,000 injections for the 2013/14 flu season alone! We also had the opportunity to listen to Jim Danahy, who told us that medication adherence should be the number one priority in every community pharmacy. I’ve already come back to my stores

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and met with my managers about how adherence can first and foremost improve patient health outcomes, and as an added bonus, improve profitable business growth. We need to come up with solutions to make sure people are taking their medications correctly, and that they continue taking them. As the health care professional on the front lines, that can include phoning individuals, reminders in our computer systems for refills, and counselling on side effects that can sometimes hinder patients from taking their medications. We also heard from our partner sponsor, the College of Pharmacists of BC, who presented a session on the new practice review being launched in March 2015. The take-away is that every pharmacy, pharmacist and pharmacy technician will be reviewed in real time, in actual practice sites, with the goal being to enhance the quality of our profession. There were so many great sessions, all of which added up to a total of 11.5 hours with eight different learning records towards the CE-Plus component of the College’s Professional Development and Assessment Program. All you need to do is log into the eServices section of the College’s website, and fill in your learning records there. Finally, a huge congratulations to all the recipients of the BCPhA Pharmacy Awards. Your accomplishments are truly inspiring, and hearing the acceptance speeches from each award winner really added to the exceptional evening gala. I hope everyone left this year’s event feeling recharged, motivated, and ready to implement best practices. For all of you who I had the opportunity to meet and network with at this year’s event, it was a great pleasure. If you missed out on this year’s conference in Whistler, I hope you’ll consider joining us next year in Victoria from May 23 to 25, 2015.


GERALDINE VANCE | CEO

Making it happen

I believe I speak for the majority

of people who attended this year’s annual conference when I say it was thought-provoking and rejuvenating. As always we are looking forward to hearing from those members who attended. The feedback is crucial to delivering conferences that meet member needs. This year our theme was Making it Happen. Why did we choose that theme? For a couple of reasons: in these times of great uncertainty and stress on community pharmacy it is easy to get discouraged and lose track of some of the amazing things that are at work in many pharmacies, and there is so much talk about pharmacy in the future that focus can shift off the success of today. So, we hope our program demonstrated that there is a great deal of innovative practice going on, that there are new opportunities to grow the business, and that those opportunities are available now. This issue provides some highlights of the conference. There were so many great idea starters and tips on how to initiate new offerings for your patients that we will be creating eTraining programs based on a number of the sessions. We will be sure to let you know when they are available on our website. I was pleased we had a number of sessions that focused on how pharmacists can work with other members of the health care team. Our physiotherapy colleagues were there to show how pharmacists can work to improve the quality of life for patients suffering with joint issues – as someone who spends a lot of time with a physiotherapist to deal with my crabby knees I was encouraged to know my pharmacist could be an important link in the process. I was also really encouraged that this year we had four physicians address the conference – one on women’s health, one on dermatology, another on travel medicine, and finally one on the issue of better collaboration between physicians and pharmacists through technology.

While it is true there are numerous challenges in building effective relationships with other health care providers, and that relationships with payers are not always easy and the downward pressure on revenue is ever present, there is good evidence that a good many are "making it happen" despite the limitations. For the last three years I have had the enviable job of calling winners of the BCPhA Pharmacy Awards to let them know that they have been singled out by their peers for their leadership and good practice. These are truly the nicest calls I make all year. And, being present for the Awards Gala ranks right up there with the highlights of the year. Talk about making it happen – this year’s award recipients are individually and collectively the best any profession could want. They all share the same quality: they are passionate about their profession. And, they all instinctively know what collaboration means and it is a hallmark of how they work. Truly an inspiration. I want to say a special thank you to Mark Dickson, who hosted this year’s awards. Each year we strive to make the annual conference better, to have a blend of clinical sessions, business and strategy. We’ve already started on next year’s conference. We were grateful for the generous support of the exhibitors at the Thursday night trade show – we had the highest number of exhibitors ever – and to the companies and organizations that sponsor the conference and awards dinner. Thanks to our co-sponsor, the College of Pharmacists of BC. The partnerships we have with all of you mean we do a better job representing the needs of pharmacists and community pharmacy. I know dollars are hard to come by these days, so your support is very much appreciated. Hope to see you all in 2015 at the Delta Victoria Ocean Pointe Resort and Spa.

www.bcpharmacy.ca

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DRUG AND POISON INFORMATION CENTRE

Focus on bupropion toxicity and abuse By Raymond Li, B.Sc. (Pharm.), M.Sc. Bupropion overdose may go undiagnosed when it is unintentional or due to medication abuse. The BC Drug and Poison Information Centre handled 95 cases of bupropion exposure in 2013. Eighty-one involved adults, with 22 therapeutic errors, 47 cases of suspected suicide, and nine cases of intentional misuse or abuse. Sixty-four of these cases were referred to hospital and 22 patients were admitted to critical care, and there was one death. There were 11 exposures in older children and adolescents, including nine suspected suicide attempts. More than half experienced moderate to severe effects, and two of these patients were admitted to critical care. There were also three unintentional exposures in children five years and younger; all were referred to hospital for observation. Pharmacology Bupropion has antidepressant effects and reduces nicotine craving by stimulating the release and blocking the reuptake of dopamine and norepinephrine, and antagonizing certain nicotinic receptors.1 Bupropion is actually a cathinone derivative, a class of chemicals related to amphetamines that includes the recreational substances referred to as “bath salts.”2 Unintentional exposures The US poison control centres reported 6,000 pediatric bupropion exposures that occurred over a seven-year period. A small percentage of these were associated with effects such as tachycardia, irritability, drowsiness, ataxia, hallucinations, lethargy and tremor with doses of bupropion up to 10 mg/kg.3 Seizures occurred in a single patient in this dose range. However, the occurrence of seizures or coma increased with higher

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doses and when the ingested dose was unknown. The authors recommended referral to a health care facility if the ingested dose was greater than 10 mg/kg (a single tablet in a small child) or if the dose was unknown. In a review of almost 500 medication errors involving bupropion reported to US poison control centres, the median dose ingested was just 300 mg (mostly sustained-release).4 The most frequent adverse effects were agitation, dizziness, tremor, GI upset, drowsiness, and tachycardia, occurring in 6 to 8% of patients, with seizures in 0.8% and hallucinations in 0.4%. Almost 25% of patients were evaluated at a health care facility. Multiple brand names and indications has caused confusion and resulted in errors - in one case report a patient was unknowingly taking Wellbutrin, Zyban and generic bupropion for a total of 600 mg bupropion/day that resulted in confusion, agitation, severe gastroenteritis and seizure.5 Bupropion abuse While bupropion’s abuse potential is low for most patients at therapeutic doses, early animal and human experiments hinted at the amphetamine-like properties of bupropion.6 On the popular “user experience” website, Erowid.org, reports of recreational use by ingestion and insufflation or snorting began appearing in 2001.7 The first report of recreational use of bupropion in the medical literature appeared in 2002 and involved ingestion of 600 mg bupropion.8 This was followed soon after by a report of bupropion abuse by nasal insufflation which resulted in a brief “buzz” and a seizure.9 There have been subsequent published cases of bupropion abuse by insufflation, with users reporting amphetamine- or cocaine-like highs, and adverse effects ranging


from nasal pain to irritability and aggression, to hallucinations and more seizures. Most of these patients had a history of substance abuse.10-16 Snorting “Welbys,” “Wellies,” “Dubs” or “Barnies” (due to the purple colour) has led to the removal of bupropion from some US prison formularies.16-18 User satisfaction following ingestion and insufflation of bupropion on the Erowid website is reported as good, mediocre, and bad. However, intravenous abuse appears to be a growing problem. While injection abuse has been described on the internet as early as 2007,19 the first report in the medical literature came from Toronto in 2013 and involved a former morphine addict. The patient was injecting bupropion every two to three hours (total of 1200 mg per day), which produced a euphoric and stimulant-like effect. The patient reported that, “a lot of people are doing this.”20 A news report from Toronto highlighted the severe skin lesions and vascular complications caused by injecting bupropion. It was estimated that nearly half of Toronto’s injection drug users had tried injecting bupropion.21 Ontario’s chief coroner issued an alert that bupropion abuse via injection or inhalation was a factor in at least six deaths in Ontario.22 In one case, inadvertent intra-arterial

injection of bupropion and cocaine into the vertebral artery resulted in a fatal brainstem infarct.23 Your role Pharmacists can help prevent medication errors and unintentional poisonings by counselling patients on proper medication use and encouraging safe medication storage and disposal. Pharmacists should be aware of the potential for bupropion abuse and can educate patients at risk, as well as other health professionals, on the potential dangers of abuse. DPIC’s website has more information on the pharmacist’s role in poison prevention and management: http://dpic.org/content/pharmacists-role-poisonprevention-and-management. If you suspect an overdose, call your local poison control centre. In BC, call 604.682.5050 or 1.800.567.8911. References available upon request; please contact the BCPhA communications team.

www.bcpharmacy.ca

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DEREK DESROSIERS  |  DIRECTOR, PHARMACY PRACTICE SUPPORT

New frontiers for pharmacy

If this year’s conference was any indication,

pharmacists are very excited about some of the new and exciting opportunities for our profession that will enable us to carve out a larger niche as part of the health care team for patients throughout BC. For example, we know from the rapid growth in pharmacy administered vaccines that the public is very open to receiving more health care services at their pharmacy than ever before. Now we’re on the verge of some very innovative programs to take us to the next level in our evolution as health care practitioners. Some programs focus on basic pharmacy initiatives such as patient adherence. We’ve all heard the expression, “Drugs don’t work in patients who don’t take them.” Estimates of medication non-adherence

with a rapidly expanding knowledge base and help patients understand the implications of genetic testing and the meaning of results. We anticipate making some exciting announcements on this front in the coming weeks. Now that pharmacists have had injection authority for a few years, a number of practitioners are looking to use that skill to expand into the area of travel health. Being a travel health practitioner isn’t as simple as “putting up your shingle” and giving vaccines, as Darin Cherniwchan reminded us in his conference session. There are many other considerations that he reviewed. Because of the significant level of interest in travel health, the BCPhA is looking into the development and/or support of a travel health education program. Stay tuned for more information in the coming months.

"Community pharmacy is well-positioned to have a significant role in bringing personalized medicine to patients ..." vary greatly, with some saying it’s as high as 50 per cent. This has a huge impact on the patient’s health, the number of hospitalizations and health care costs. The presentation by Jim Danahy at this year’s conference made the case that medication adherence improves both patient health outcomes and profitable business growth more than any other factor, and should be elevated to the top priority in each and every pharmacy. At the BCPhA we are working on a revamping of the Trial Rx program and Medication Review Services to focus more on chronic conditions and adherence, and ensuring these services are directed at patients who will benefit most. Community pharmacy is also well-positioned to have a significant role in bringing personalized medicine to patients in terms and services that are meaningful. “Personalized medicine” is a very broad term that means different things to different health care professionals. For community pharmacists, there will be challenges as well as tremendous opportunities. Pharmacists will be expected to keep up

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As pharmacists continue to expand our scope of practice, it’s apparent we also need to work more closely with other health care practitioners. While many pharmacists already have strong relationships with physicians in their area, other practitioners are often overlooked as a source of support. How many times have we had patients complaining of sore joints, looking for relief from an OTC when we know they should probably be seeing a physiotherapist? Or many muscular related sports injuries that may call for a referral to a massage therapist? By strengthening our partnership with other health care practitioners such as physiotherapists, massage therapists and chiropractors, we can all do a better job of helping patients prevent and manage chronic disease by participating in safe and effective physical activity. As pharmacists we have to think differently about the types of services we provide to our patients for their health and wellness. In doing so we’re much more likely to ensure the long term viability of community pharmacy businesses as well as getting much more personal satisfaction from our professional careers.


CYRIL LOPEZ, CHIEF OPERATING OFFICER

Professional judgment = risk exposure You can and must take steps to mitigate the risk

Risk management is the identification and assessment of risks followed by an economical application of resources to control the adverse events while maximizing the opportunities. Everyone has heard of the “risk-reward equation.” Where most of us fail is in identifying risks and the cost implications. Or, not realizing we are assuming risk.

Risk presents itself to me every day and every time I make a decision, provide advice or take action, from strategic to the mundane tasks: developing financial plans, managing personnel issues, ensuring internal controls at the Association, providing financial information and forecast, approving invoices, signing cheques, reviewing vendor proposals, etc. The risk here is that I don’t have all the information I need to make a good decision; that I did not take adequate steps to becomes fully aware of the applicable laws. These laws could restrict my ability to independently exercise my professional judgment. Professional judgment has a box around it. It must be exercised within the confines of applicable laws. I hate paying income taxes but cannot ignore the laws that govern taxation right up to the different boxes required on the CRA tax forms. Since I have no options, I use a reputed tax filing system or a tax professional. Compliance is cheaper than non-compliance.

iii. Share: This is more applicable to owners sharing risk of a new practice amongst partners. Within the pharmacy service team, each professional is responsible for their individual actions. Each professional expects the other is doing their part to mitigate risk to the team. iv. Insure: This is the easiest one. Go out and buy protection. But, the insurer will only cover you for an approved pharmaceutical service. It must be approved by the College of Pharmacists of BC. It is prudent to ensure that in event of a claim for malpractice, you can point the insurer to the College’s Practice Manual that covers your practice. Know your risks. Don’t focus only on the reward side of the equation. Rules change. v. Retain: We retain risk all the time without realizing we are doing that. Every time we go over the speed limit. If you decide to retain risk then keep money aside to pay that speeding ticket. The pharmacy is always busy with many tasks to be undertaken quickly for impatient patients! You can mitigate your financial and professional risk by identifying and assessing your environment’s risk factors. You may find that it is prudent to incur incremental costs to protect the reward stream. The risk profile of your practice may have changed over the last few years. Like the payable accountant who will not process a reimbursement without the parking ticket, you may need a compliance officer at the counter running interference 24/7.

Risk mitigation is a complex science but has a handful of simple steps. Before mitigating risk, you must identify then assess the risks. Once Prevention is cheaper than cure. Your investment in compliance may that is done, your choices are: progroup_ad_v3.ai 13/11/2008 4:23:24 PM improve your bottom line. i. Avoid: If you don’t drive you don’t cause a driver-error collision. Avoid taking risk unless you can absorb the cost of that risk. You know how it feels if you invest in a stock that does not perform to expectation. In your practice, avoid delivering services unless you understand all NEW CAR PURCHASE PLANS applicable rules. member benefit partner All Makes & Models C

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ii. Transfer: If you cannot avoid then transfer the risk to someone else. This strategy may not be practical for professionals.

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CLINICARE PHARMACISTS

The quick and easy on urinary incontinence By Larry Leung and Jason Min

In our practice, we have been fortunate to follow our

patients over many years, giving us the opportunity to screen and manage urinary incontinence on a regular basis. There are three main types of urinary incontinence: stress, urge, and overflow. It’s important to note that overactive bladder is a different condition, but can include and lead to urinary incontinence. When we discuss urinary incontinence with our patients, we typically ask: “How often do you leak urine? Do you ever leak urine when you cough, laugh or exercise? Do you ever feel like you are unable to fully empty your bladder?” This helps determine the type of urinary incontinence a patient may have. We recently received a patient referral for reassessment of their urinary incontinence. Our patient was a 65-year-old male diagnosed with urge incontinence that was somewhat controlled with therapy. The patient frequently voided, every two hours, throughout the day before starting oxybutynin, but it had improved to every three hours. Possible causes such as diabetes, depression, mobility issues, and cognitive impairment were all ruled out. He did not experience worsened symptoms in the evening, and was interested in options to further improve his symptoms. His only other medical condition was hypertension, which was not well controlled with an average blood pressure of around 150/85 mmHg.

The patient was taking the following medications: • Oxybutynin IR 5 mg twice daily • Ramipril 10 mg once daily • Amlodipine 10 mg once daily The physician had the following questions: 1) Would switching to another agent with anticholinergic effects offer more benefit? Anticholinergic agents help to decrease detrusor muscle contractions and relax the bladder, which in turn can decrease urgency. The differences in efficacy between the anticholinergic options (e.g., tolterodine, solifenacin) are not compelling and we would not expect this to be helpful for the patient. In choosing an anticholinergic agent it is important to consider cost, dose frequency, interactions, and if the product has an extended-release or immediate-release availability.

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Given that our patient had good adherence and was tolerating his medications, we did not think it would be worth making a switch to an alternative anticholinergic. 2) Would the addition or substitution with mirabegron be an appropriate option? Mirabegron is a beta-3 agonist that relaxes the bladder smooth muscle and increases bladder storage capacity. Currently, there is not enough evidence to suggest that the addition of mirabegron to anticholinergic therapy is safe or more effective. We also didn’t recommend using mirabegron due to the possible increase in blood pressure, which in our patient was an important consideration. For our patient, switching to another anticholinergic or adding mirabegron were not appropriate options. Instead, we recommended optimizing the dose of oxybutynin to 5 mg three times daily, with the option of titrating to a maximum of four times daily if tolerated. There is a relative lack of evidence to guide the treatment of urge incontinence in men versus women. For men who have urge incontinence associated with benign prostatic enlargement (BPH), alpha blockers (e.g., tamsulosin, terazosin, etc) could also be used as an alternative. A note to the physician was sent to ensure that BPH was screened for. What would you have recommended? When would you consider other medications such as tricyclic antidepressants or desmopressin? Thank you to our astute readers who pointed out an error in our last article on diabetes. We referred to a number of different therapeutic options available in the treatment of diabetes and included the glucagonlike-peptide 1 (GLP-1) agonists as an oral dosage form. Of course, GLP-1 agonists, such as liraglutide, should be given by subcutaneous injection and we would not recommend taking it orally.

Larry Leung and Jason Min are directors of Clinicare Pharmacists Inc. and lecturers at the University of British Columbia. They have a passion for interdisciplinary care and the development and implementation of innovative clinical pharmacy services in the community. They do not have any disclosures or conflicts of interests to report. References available upon request; please contact the BCPhA Communications team.


STUDENT NEWS

Be an agent of change By Aaron Sihota

It was a big year

for the University of British Columbia’s Faculty of Pharmaceutical Sciences and its students! From the opening of Canada’s first universityaffiliated, licensed, patient care centered pharmacy (The Pharmacists Clinic) to the establishment of a new Entry to Practice PharmD program, we can be assured that our program is ready to equip students with the necessary skills and attitudes to respond to the health care challenges of today and the future. Our students forged strong relations with the BCPhA through a number of Association initiatives such as the Student Ambassador program, including students in its advocacy programs, and sponsoring students to attend the annual BCPhA conference. In addition, we worked with the College of Pharmacists of BC to create a student observer seat to help give us a better understanding of, and input into, the College’s work. Finally, our Faculty members never cease to amaze, as mentors both inside and outside the classroom. They made this a great year for UBC pharmacy students! To my fellow graduates, the UBC Pharmacy Class of 2014 – congratulations on making it through the journey. And what a journey it was! I hope in the last four years you grew as a person, gained a better appreciation of the world around you, and saw issues from the perspective of a different lens. We are at such an exciting time in the world of pharmacy – more outcome-focused patient care, more team-based care, and the delivery of more specialized services. At the same time we face a highly competitive economic environment, generic drug rebate reductions, and both internal and external resistance to change. How will you address these issues? What will you do to advance your own practice and our profession? Pharmacy is a very small community, which makes it very special. To the students joining this practicing community, I encourage you to be an agent of change in your local community, do your part to advance our profession, and serve the needs of your patients. I look forward to hearing about your accomplishments and working alongside you as a colleague. Aaron Sihota is a BCPhA Student Ambassador and one of the recipients of the 2014 Apotex Inc. Future British Columbia Leader Award. A recent graduate of the UBC Faculty of Pharmaceutical Sciences, Aaron is now looking forward to serving the needs of patients while advancing the pharmacy profession.

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GLENN SCHOENROTH I FINANCIAL TRENDS

Preparing the next generation for wealth

Passing wealth

to the next generation, while ensuring they are ready for the responsibilities that come with it, is an important goal for many families.

Start early by teaching financial responsibility Parents often achieve their financial success through hard work and careful financial management, but worry their children won’t appreciate the effort required to become financially successful. Teaching children a healthy regard for money early on can help address this concern. For example, consider limiting your child’s spending by giving them an allowance to divide equally between spending, saving and charitable giving. Or, open their own bank account to save for longer-term goals and consider co-funding larger consumer purchases with your children on a 50/50 basis.

Do it in stages Many families prefer to pass on wealth in stages, helping beneficiaries become accustomed to the responsibilities that accompany it. Burning through an initial gift installment can be a valuable lesson for children and a warning sign that more parental guidance may be needed.

You can also use trusts to distribute wealth in stages after your death. Instead of giving a beneficiary their entire inheritance, you can establish a testamentary trust in your Will that provides funds with specific conditions. For example, the trust can pay your beneficiary a certain amount while a minor, then more at the age of majority.

Involve your beneficiaries ahead of time Often beneficiaries receive their inheritances without adequate preparation, leading to conflict and confusion when the estate is being settled. Make sure your beneficiaries understand how you plan to settle your estate, and what roles they may have. If you appoint a beneficiary as executor, they may be responsible for multiple duties, including managing or selling real estate; distributing the estate according to the terms of the Will; filing all required documentation including final tax returns; and assisting with asset valuation and preparing a formal inventory. If they are uncomfortable with these responsibilities you may want to consider alternatives, such as another executor, a co-executor or a professional executor. It’s also important to give them the power to delegate duties to professionals.

During your lifetime, you can simply give money to your beneficiaries for any number of reasons, such as a down payment on their first home. Generally, there are no tax consequences from such a gift (unless you sell an asset with a tax liability first, then give the proceeds).

Are you bequeathing an investment portfolio to beneficiaries who are less experienced with managing investments than you? Consider introducing your beneficiaries, especially those acting as executor or Power of Attorney, to your investment advisor. This can help them become more comfortable making investment decisions later on.

You can also set up a family trust to provide regular funds to beneficiaries, for example, for their education. You can gift or loan assets to the trust while saving on taxes, since the income earned within the trust, when used for a trust beneficiary’s benefit, is taxed in their hands. A certain amount of income will be tax-free due to the beneficiary’s basic personal amount, and thereafter taxed at their marginal tax rate.

This article is supplied by Glenn Schoenroth, CFA, Vice President and Portfolio Manager with RBC Dominion Securities Inc. (Member– Canadian Investor Protection Fund). This article is for information purposes only. Please consult with a professional advisor before taking any action based on information in this article. Glenn Schoenroth can be reached at 604.257.7196.

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GOVERNMENT RELATIONS

Push for pharmacy services goes on

by Coco Lefoka

The spring session

of the BC legislature concluded on May 29. Spring sessions of the legislature are traditionally the busiest as they usually involve the passage of a budget. This year’s was no different and was marked by a flurry of activity. The activity started with the province’s 85 MLAs debating the legislative agenda that the government had outlined in its throne speech. MLAs debated 42 pieces of legislation, including 27 government sponsored bills. A host of other laws were also amended during the sitting. Two bills relevant to health care were passed during the session: Laboratory Services Act – The legislation sets a framework for standardizing BC’s clinical laboratory system. Changes in the act allow the government to integrate the province’s laboratory system and bring under one framework all laboratory services provided in hospitals and at the community level. Budget 2014 (Budget Measures Implementation Act) – The provincial budget included a $100 million reduction to the PharmaCare budget. This reduction has been explained as being the result of savings the government has derived from generic drug pricing regulations and pricing reductions through the Pan-Canadian Generic Drug Pricing Initiative.

During debate about the health ministry’s budget estimates, Minister Terry Lake said the following: “the...decrease in the pharmaceutical line in the budget represents about $100 million. That's what we (government) estimate we will save through all of our initiatives, whether it's the generic side of things or the brand-name productlisting agreements.” Notably in the budget, the government expressed its interest in “developing opportunities for pharmacists and physicians to work together to improve the optimal use of drugs” to get better patient outcomes. This was viewed as an indication that BC was set to initiate the positive reforms to pharmacy services that other provinces have undertaken. That BC now lags behind other provinces in expanding pharmacists’ role in the health care system was a key message the Association delivered to MLAs during the Pharmacy Day held at the legislature in March. Additionally, the BCPhA provided government with ways to begin realizing the very opportunities in which it expressed interest. In March, the Association followed up on the clinical services proposals it released in 2013 with a policy paper that provided recommendations on ways to control prescription drug spending while improving

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access and the quality of care that British Columbians receive. Better pharmacist and physician collaboration on patient care was among these recommendations. Yet progress on this front remains stayed. Certainly there is increased awareness and support among MLAs about the vital and important role pharmacists play in BC’s health care system. Pharmacy’s increasing immunization rates are just one area where pharmacists are demonstrating their effective ability to deliver health services that are accessible and meet patient needs. Additionally, there is growing recognition that pharmacists offer opportunities for the Province to address the challenges of containing health care costs while ensuring continuing and timely access to high quality care. The pace of progress on the legislative front illustrates that change won’t come by easily. But pharmacists must continue the hard work of advocating for BC to make the policy changes necessary so broader clinical services can be made available in pharmacies. After all, broadening pharmacy services will have a positive impact on BC’s health care system.

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BCPHA ANNUAL CONFERENCE 2014

Highlights of the BCPhA Annual Conference 2014 Members of the pharmacy

community gathered in Whistler from May 22 to 24 for this year’s conference Making it Happen: Implementing Best Practices. The conference kicked off on Thursday evening with a Mardi Gras-themed trade show and networking event featuring new and returning exhibitors, great food, prizes and the chance for pharmacy friends and colleagues to mix and mingle.

Both Friday and Saturday were jam-packed with speakers, educational sessions and panel discussions covering a range of topics relevant to both the business and the practice of pharmacy. Friday evening we honoured the outstanding recipients of this year’s BCPhA Pharmacy Awards at our gala dinner. See page 19 to learn more about each award recipient.

This year’s conference program was worth a total of 11.5 hours towards the CE-Plus component of the College’s Professional Development and Assessment Program.

BCPhA members Hemant Makhija, Shoppers Drug Mart; Chandra Erant, Target; and Gopala Gaddam, Safeway, got in the Mardi Gras spirit of the trade show and networking night. Bob Nakagawa, registrar of the College of Pharmacists of BC and this year’s partner sponsor, presented a session on Community Pharmacy and the Focused Practice Review.

BCPhA Board member Julie Ford and Diamond sponsors JoDee Schmidt and Shannon Norris, Bayer Canada.

Jo-Ann Stuart Chatterley, Janssen Pharmaceutical Companies, and Dennis Wasylow, Lifescan Canada, were recognized as Diamond sponsors at the Awards Gala.

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Shoppers Drug Mart celebrated Omar Alasaly’s Pharmacy Leadership Award: (from left to right) Nemanja Filipovic, Jeannette Wang, Omar Alasaly, Karen Sullivan, David Pavan and Alex Dar Santos.

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Doug Stephens, one of the world’s foremost retail industry futurists, opened the conference sessions on Friday with his keynote speech on The Future of Retail Pharmacy.

So You Wanna Become a Travel Health Pharmacist? Darin Cherniwchan discussed how travel health services can be introduced into a clinical pharmacy setting.

Pharmasave Pacific Ltd.’s Dave Reston, Joanne Reston, and Mylan Pharmaceuticals’ Robert Herrington attended the Awards Gala (left to right).

John Shaske, Howe Sound Pharmacy; Jennifer Dunkin, consultant pharmacist; and BCPhA Board member Shakeel Bhatti.

Karen Wolfe, Target Pharmacy; Dayle Acorn, Canadian Foundation for Pharmacy; and Sherry Peister, Canadian Pharmacists Association joined in the celebration of the 2014 BCPhA Pharmacy Awards.

Atul Goela, Green Shield Canada (left) and Jason Kennedy, TELUS Health (far right) participated in a panel discussion on Innovations in Drug Plan Management, facilitated by Sam Louie (middle).

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Tony Stanic, Galenova, was one of more than 35 exhibitors at the trade show and networking night.

Elizabeth Robinson, Sanofi Pasteur Ltd., was an exhibitor and Diamond sponsor.

Joe Gallager, CEO of the First Nations Health Authority, presented on the New First Nations Health Authority’s Health Benefits Program.

Sara Levine and Drew McArthur (not pictured) hosted an interactive workshop on health care consent and privacy consent.

Unjali Malhotra discussed A Lifetime of Reproductive Health.

Dan Martinusen presented a session on Subsequent Entry Biologics: A primer.

Cheryl Wong and Patrick Davidson, Pacific Blue Cross.

UBC Faculty of Pharmaceutical Sciences students and BCPhA ambassadors Renee Dagenais and Jason Alessio; along with student volunteers Jered Kelly and Mitch Prasad (left to right), manned the registration table and networked with practicing pharmacists.

CustomerLab CEO Jim Danahy made an evidence-based case for medication adherence to be The Only Best Practice That Matters.

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2014 BCPHA PHARMACY AWARDS

Congratulations to this year’s recipients!

Celebrating the 2014 BCPhA Pharmacy Award recipients: (from left to right) Joelle Mbamy, Stephanie Hahn (accepting on behalf of Adeline Tan), Jason Min, Chris Cameron, BCPhA CEO Geraldine Vance, Mike Dilfer, Ken Foreman, Dawei Ji, Omar Alasaly, Don Fraser, Aaron Sihota, Cam Bonell and BCPhA president Don Cocar.

Achievement Award

Apotex Inc. Future British Columbia Leader Award Cam Bonell, Clinical Community Pharmacist, Lakeside Medicine Centre, Kelowna

Cam Bonell is well-recognized by both patients and peers for his tireless work to help educate. He is a patient educator for the Central Okanagan Association for Cardiac Health rehabilitation program and has been co-chair of the Board of Directors since its inception in 1998. He works BCPhA Board member Randy with the regional transplant clinic to Konrad (left) and Cam Bonell. ensure seamless care for transplant patients and also educates newly-diagnosed renal patients. His patients value him as an important member of their health care team, seeking his advice on anything and everything. Cam is hospital residency trained, but ultimately found his home in community pharmacy. He has been Kelowna’s regional coordinator for continuing pharmacy professional development for the UBC Faculty of Pharmaceutical Sciences for almost 19 years. Since 2009, Cam has trained many of his peers as a lead Administration of Injections Program trainer with the BCPhA. Within the profession, he is recognized as a knowledgeable speaker on a variety of pharmacy business and clinical topics.

Dawei Ji Aaron Sihota Both Dawei Ji and Aaron Sihota have shown remarkable engagement in the Faculty of Pharmaceutical Sciences at the University of British Columbia. As a first-year pharmacy student, Dawei designed and coordinated a Facultyapproved elective course on the business of biotechnology and pharmaceuticals. He was involved in organizing events such as Dawei Ji; Paul Buxton, director, corporate accounts, Apotex Inc.; and Pharmacy Awareness Week at UBC, and Aaron Sihota (left to right). served on the Pharmacy Undergraduate Society (PhUS) Council as General Councillor during his third year. In his final year, Dawei completed a research project that explored how innovative clinical services could be effectively implemented within community pharmacy practice. During his four years as a pharmacy student, Aaron served on the PhUS Council in various roles including a one-year term as President, and for two terms representing the Faculty on the university's academic governing body, the UBC Senate. He was recently invited to present at the Canadian Agency for Drugs and Technologies in Health Symposium on a project he completed with the UBC Pharmacists Clinic, exploring patient perceptions of the services provided by the Clinic and which groups of patients would best utilize these services. Like Dawei, Aaron has been a BCPhA Student Ambassador since the program first launched in 2011.

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Ben Gant Innovative Practice Award

Lifetime Achievement Award

Larry Leung and Jason Min, Directors, Clinicare Pharmacists Inc.

Jason Min (left) and Larry Leung.

Clinicare Pharmacists, founded by Larry Leung and Jason Min, is a nondispensing pharmacy organization that has been providing innovative patient care services since 2010. A dynamic team of specialists in clinical pharmacy practice, they are dedicated to working as part of the community health care team to improve patient outcomes.

Partnering with local nurses and Aboriginal community members, Larry and Jason established clinical pharmacy services for the home and community care programs of Bella Bella, Bella Coola, Klemtu and Mount Currie. Services include clinics (e.g., blood pressure, foot care, fall prevention), home visits, patient education and academic detailing to local health care team members. Jason and Larry’s work has formed the basis of an Aboriginal Health elective now offered at UBC. They are lecturers at UBC’s Faculty of Pharmaceutical Sciences and School of Nursing, and patient care practitioners at the Pharmacists Clinic. They were also the 2014 recipients of the BC Community Achievement Award.

Friend of Pharmacy Award

Ken Foreman, Manager, Pharmacy, Pharmasave Drugs (Pacific) Ltd. Since graduating at the top of his class from UBC's Faculty of Pharmaceutical Sciences in 1976, Ken has contributed to every facet of pharmacy practice to ensure the profession continues to move forward. His career includes terms as president of both the BCPhA and College of Pharmacists of BC, guest lecturing at the UBC Faculty BCPhA president Don Cocar (left) of Pharmaceutical Sciences, and and Ken Foreman. involvement with the Ministry of Health, Doctors of BC, and Chain Drug Association of BC. He has been instrumental in seeing pharmacy through many challenging times, including the introduction of PharmaNet in the 1990s to more recent negotiations with government, payers, and other stakeholders. Ken was BCPhA deputy CEO and director of professional services from 2001 to 2005. He has been a trusted adviser to BCPhA staff and CEOs, and mentor to other Board members. Ken was also the deserving recipient of the 2010 Murray Dykeman Mentorship Award.

Murray Dykeman Mentorship Award Don Fraser, CEO/President and Owner, Forewest Holdings

Don Fraser’s 29 pharmacies employ numerous pharmacists and provide much needed pharmacy services in small and large communities across BC. This role gives him the opportunity to shape pharmacy practice and support his pharmacists in offering injections, Medication Reviews and disease state management. His coaching and BCPhA Board member Greg mentoring allows pharmacists to Shepherd (left) and Don Fraser. embrace scope of practice changes and look for ways to grow profitability while providing exceptional patient care. Don also invests in store design and technology to allow his team to maximize their delivery of pharmacy services. Don was an early contributor to the Pharmasave organization, and served on the Pacific Board from 1991 to 1999 and again from 2002 to 2011. He was also on Pharmasave’s National Board from 1994 to 1996, and his passion and tremendous knowledge of the industry has been of huge value to the company. Don is a champion of community pharmacy, pharmacists and the valuable services and contributions that community pharmacy brings to patients across the province.

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Mike Dilfer, Pharmacist, Target Pharmacy, Courtenay

BCPhA Board member and past-president Ralph Lai (left) and Mike Dilfer.

To be a good teacher or leader, you have to be a good listener – and Mike Dilfer is an exceptional one. Students, peers and patients alike agree he has an uncanny ability to find out what people are really saying and help them. Mike regularly mentors pharmacy students and was nominated by those who admire his passion for the profession and drive to learn. He always engages students and new coworkers, supporting them through both personal and professional challenges.

Leading by example, Mike gives every patient his focus while providing evidence-based care. His peers are inspired by his ability to form therapeutic relationships with clients and motivate them to do better for themselves. His pharmacological background is just as strong as his personal skills – Mike is always on top of the latest literature and recently helped launch a monthly meeting for pharmacists in the Comox Valley to discuss practice issues. Consistently growing as a pharmacist himself, Mike makes everyone around him better at the same time.


Pfizer Bowl of Hygeia Award

Takeda Magnum Opus Award

Joelle Mbamy, Pharmacist, Owner, Sunrise Pharmacy, Penticton Since opening Sunrise Pharmacy in 2012, Joelle Mbamy has focused on making her community better. As a certified Safe Harbour location, she offers equitable treatment for all and an immediate safe place for someone experiencing discrimination. Diverse groups rely on Joelle's pharmacy as a symbol of trust in the neighbourhood. Ross Douglass, medical district Her practice is tailored to the needs manager, southern Alberta & of her community, including being a British Columbia, Pfizer Consumer Healthcare (left) and Joelle Mbamy. Naloxone distributor to assist in drug overdoses and becoming certified in foot care to help those in need take better care of their feet. Joelle’s compassion extends beyond her four pharmacy walls as she volunteers with the Penticton & District Community Resources Society and its Harm Reduction Program, helping individuals access much needed resources to get them back on their feet. She runs health clinics at the Sikh Temple, attends the annual Senior Centre Health Fair, and is part of the South Okanagan Immigrant Community Services Society.

Pharmacy Leadership Award

Adeline Tan, Pharmacist, Safeway Pharmacy, Vancouver Adeline Tan is a Certified Diabetes Educator and a knowledgeable, skilled and caring pharmacist. Her patients recognize her as an expert in her field, always taking the time to thoroughly answer customer questions from drug interactions to nutritional supplements. Adeline conducts diabetes clinics and is acknowledged as a diabetes expert Award recipient Adeline Tan. and evidence-based practitioner in the community among local physicians, pharmaceutical companies and colleagues. She is dedicated to her patients, the profession, and continuing education. Adeline has forged new networks with local community groups and various senior centres. She participates in annual health and wellness fairs including the Richmond School District Convention, BCIT Health Risk Assessment Screening and TELUS Walk to Cure Diabetes. She advances the pharmacy profession through clinical services including immunizations, osteoporosis education, insulin starts, and anemia and cholesterol management. Adeline also actively mentors pharmacy students, technicians and assistants.

Voice for Pharmacy Award

Omar Alasaly, Associate-Owner and Pharmacy Manager, Shoppers Drug Mart, Victoria

Chris Cameron, Pharmacist/Owner, Pratt’s Compounding Pharmacy, Kamloops

Omar Alasaly’s staff and colleagues can attest to the fact that his passion and enthusiasm for the profession are contagious. He encourages pharmacists to embrace their role as medication experts, and leads by example providing professional services such as Medication Reviews, BCPhA vice-president David Pavan immunizations, smoking cessation (left) and Omar Alasaly. clinics and diabetes management clinics. Due to his support, his pharmacists have all attained their injection certification.

Over the past 15 years, Chris Cameron has done an excellent job representing pharmacy both professionally and through his volunteer work. His pharmacy, Pratt’s Compounding Pharmacy, was recognized by his peers with the 2012 uniPHARM Best Practices Award, and BCPhA Board member Allison Nourse by patients with the Readers’ Choice (left) and Chris Cameron. Best Medical Supplier and Pharmacy in Kamloops. It was also nominated by the Kamloops Chamber of Commerce as Business of the Year.

Omar trains and mentors new pharmacists, and is a preceptor for UBC and International Pharmacy Graduates. He is active in the profession as vice-chair of the College of Pharmacists of BC’s Injection Drug Administration Committee and on the Pharmacy Examining Board of Canada (PEBC) Board of Directors in Toronto. He is involved in pharmacy technology projects that are finding ways to enable pharmacists to spend more time focusing on professional services. Omar has been recognized by his peers as being a pharmacy and business leader, and was elected as the Shoppers Drug Mart BC Peers Chair, where he represents all the associate-owners in BC to senior management.

Chris is often the go-to pharmacist in Kamloops for pharmacyrelated media inquiries. He is a member of the BCPhA’s MLA Outreach Program and active in his community as a guest speaker. Chris has discussed the important role pharmacists play in helping patients with their medications at many non-profit groups including the Parkinson's Awareness Group, Kamloops Brain Injury Association, and the Interior Chemical Dependency Group. He is also a guest speaker at Thompson River University’s Sleep Conference and a number of continuing education events for respiratory therapists and pharmacists.

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RENALLY-SPEAKING

Renal pharmacy myth busting

By David Massaro, B.Sc., B.Sc. (Pharm.), R.Ph. Reviewed by Clifford Lo, B.Sc. (Pharm.), PharmD, MHA, BCPS, and Dan Martinusen, B.Sc. (Pharm.), ACPR, PharmD

If you are tempted

to skip over this new column dedicated to all things “renal” because you don’t manage kidney patients in your community pharmacy and figure it won’t apply to your day-to-day work, please give me one minute to convince you otherwise. Do you see older, poorly-controlled diabetic or hypertensive patients? My guess is yes, and likely quite a few. In that case, this column is very relevant to your practice, and my aim is to ensure it is both informative and practical. I spend half my week in the dialysis units of Surrey Memorial Hospital (SMH) and the surrounding community dialysis sites. I see first-hand the repercussions of long-term hypertension and diabetes as well as drug-related kidney injury and other immunological or infectious events. These patients, whose kidneys have failed, must spend an average of 12 hours per week (three four-hour visits) hooked up to a dialysis machine, just to stay alive. Before I joined the renal program (less than a year ago), I worked in a variety of clinical settings and specialties, including most recently an interdisciplinary chronic pain clinic in Surrey where I still spend the other half of my week. Other than a brief rotation as part of my community residency program, nephrology was uncharted territory for me. Thanks to my talented mentors and colleagues on the SMH renal team, I’ve not only gained an increasing level of expertise in kidney care, I’ve realized there are many perceptions and assumptions about nephrology that are false. With that in mind, I’d like to dedicate my first renal column to myth busting! 1. Truth or myth? As a community pharmacist I shouldn’t overstep my boundaries if I see something potentially amiss with medications, as that’s the territory of the nephrologists and renal pharmacists.

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Obvious myth! Patients with known renal impairment or end stage kidney disease are on an average of 19 regular medications1 making it an arduous task simply to reconcile them all, let alone optimize therapies. The more eyes and ears, the better. Starting and stopping medications is always a potential issue. If you think there may have been an oversight or the patient confirms non-adherence with their medications, the nephrology team, starting with your local renal pharmacist, needs to know. Do not assume they do! Although this mostly applies to BC Provincial Renal Agency contracted pharmacies, patients can go anywhere for their other prescriptions and overthe-counter medications, which makes this situation applicable to any pharmacy. Renal patients of any kind are perfect candidates for a Medication Review – but please share your findings with the nephrology team, too! 2. Truth or myth? There are set guidelines for medication dosing and frequency in renal impairment and dialysis. Kind of truth and kind of myth. Dose reductions in renally-cleared medications typically occur at creatinine clearances under 30 mL/ min but even then the guidelines can be somewhat cryptic. Once someone is on dialysis, the grey zone widens even further. Check out www.dialyzeihd.com created by Dr. Marianna Leung at St. Paul’s Hospital, as this can be a useful tool for hemodialysis-related pharmacokinetic queries. But the real take-home lesson is that despite all the best intentions of guidelines, nothing beats monitoring your patient for treatment effectiveness and adverse effects, some of which may be related to drug accumulation. This is where we can all practice to our full and most impactful scope – a reward in itself! Do you need to look for anything special? Some patients may have marked reduction in urine production or complain of uremic


syndrome symptoms (see the next Tablet for details). Otherwise, they will experience the same side effects typical for the medication in question. 3. Truth or myth? Blood pressure targets of <130/80 mmHg are appropriate for diabetic patients whether they’re on dialysis or not. Myth (in practice)! During hemodialysis, some patients may experience wide fluctuations in blood pressure. With fluid removal during dialysis, hypotension and loss of consciousness becomes a significant concern. Other patients can experience systolic pressures over 200 mmHg requiring Captopril for immediate treatment. Unfortunately, blood pressure targets are not well established for the dialysis population and require further research; the rule of thumb here is that stable blood pressures slightly above 140/90 mmHg, even in a diabetic patient, are usually not something requiring therapeutic intervention unless there is an ongoing trend upwards. For diabetic patients with chronic kidney disease not on dialysis, blood pressure targets also depend on urine albumin excretion. A target of <130/80 mmHg is only recommended when urine albumin excretion is >30 mg per 24 hours (or equivalent).2

This article has just scratched the surface with respect to myths in kidney patient care. It is no myth, however, that our patients benefit if community pharmacists stay connected to their hospital colleagues. We have a lot to share with each other and I cannot think of a better partnership to maximize the well-being of our patients – especially those with renal impairment or on dialysis. David Massaro is a community-based clinical pharmacist who shares most of his time between two sites in Surrey: Surrey Memorial Hospital's outpatient renal dialysis unit and Orionhealth, an interdisciplinary chronic pain and rehabilitation clinic. He is an enthusiastic supporter of any initiative that involves all pharmacists practicing to their full scope, regardless of practice environment. References: 1. Kaplan B, Mason NA, Shimp LA, Ascione FJ. Chronic hemodialysis patients. Part I: Characterization and drug-related problems. Ann Pharmacother. 1994;28(3):316-319. 2. KDIGO Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Disease Improving Global Outcomes; 2012. Available at: http://www.kdigo.org/clinical_practice_guidelines/pdf/KDIGO_BP_GL.pdf.

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PHARMACY PROFILE: STSRX

A space outside the dispensary By Elise Riedlinger “After surgery and a few days in hospital, patients are in a peculiar position,” he said. “They’re no longer in contact with the hospital, and their general practitioner might not be aware of what happened. They often end up in ‘no-man’s land’ on brand-new medications with a lot of space for confusion.

Opened in November 2013, Specialized Therapeutic Solutions Rx (STSRx) is not your typical storefront pharmacy and dispensary. Its owner, Alain Vincent, has created a business that focuses on clinical pharmacy services and aims to make the most of pharmacists’ expertise in complex pain management and chronic disease care. Alain’s model has pharmacists working as independent contractors in physicians’ offices, clinics and seniors centres, and focuses on Medication Review Services for patients who need the service the most. STSRx acts as coordinator and marketing headquarters, finding partners interested in offering the service within their practice. Medication Reviews are also offered in patients’ homes for those recently discharged from hospital or with mobility issues, and free presentations are given to long-term care facilities and home support services to show what pharmacists can do – from adaptations to initiating drug trials. “With pharmacists being pushed to redefine their roles as the result of generic drug reforms, the timing may be right for a new way of doing things,” said Alain. Originally from Haiti, Alain co-founded his own pharmaceutical manufacturing company there called Faramtrix, S.A., after completing his pharmacy degree in 1988 at the Arnold and Marie Schwartz College of Pharmacy in New York. Six years ago, he moved to Victoria, BC, and began working as a hospital pharmacist for the first time. It was this experience that got him thinking about a niche service.

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“It can even be hard to get to a trusted community pharmacy if a patient is in pain and stuck at home. That’s why I created this service.” Citing one example, Alain worked with a patient who was discharged after shoulder surgery and began experiencing hallucinations. The patient’s relative, a home support service worker, had seen one of Alain’s presentations on Medication Reviews and asked for the service. During the review, Alain discovered the patient’s new painkiller, tramadol, was interacting with antidepressants she was taking. He called the patient’s primary physician, who didn’t know that tramadol had been prescribed in hospital and discontinued it. Then, because the patient still needed break-through pain control, Alain suggested a prescription for that from the physician, and had the medication delivered directly to her. “Just the simple fact that a pharmacist can call a physician directly makes a huge difference,” he said. “A patient can’t always do the same, and often has to wait for an appointment or worry about getting to the doctor’s office.” Alain has received great feedback from the physicians he works with. His objective is to have his team of pharmacists go into clinics

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one or two days a week to see eligible patients (on five or more medications), particularly those with chronic diseases such as diabetes or hypertension. “With pharmacists working alongside doctors, we find that patients’ medication problems can be solved immediately. There’s great satisfaction in having a medication expert right there in the office, and patients are pleased to have at least 20 to 30 minutes with a pharmacist in addition to their doctor’s visit. It’s really a win-win situation.” There are currently three pharmacists who work with Alain, and those who are parents particularly enjoy the flexibility of the Medication Review schedule and part-time hours offered. “A lot of pharmacists want to do more clinical work, and this way they can give attention and time to each individual patient.” Next, Alain hopes to expand beyond Victoria and the south Island to find additional physicians willing to have pharmacists work within their offices. “It’s a new concept, so some physicians don’t immediately see the value of the service and what pharmacists can do for them. But I recently attended a conference where patients were asked what they’d like to see in their health care: one suggestion that kept coming up was more health care practitioners working together in one office, such as nutritionists and pharmacists. I think this could be the way of the future. “It’s exciting to see that there can be a space for pharmacists who are willing to get out of the dispensary.”


CAREER LISTINGS

ARE YOU MAXIMIZING THE VALUE OF YOUR MEMBER BENEFITS? Pharmacy members can place free Career Opportunities listings in this section and on the BCPhA website. Job postings for pharmacy technicians and assistants are also distributed by the Pharmacy Technician Society of British Columbia (PTSBC). A new enhancement to the best pharmacy job board in BC! Pharmacist members looking for new career opportunities can post their resumes for free on the Hire-aPharmacist page. To learn more, visit the Recruitment section of bcpharmacy.ca ABBOTSFORD Pharmacist – part-time Pharmasave is looking for a part-time pharmacist (weekends) who has been practising for at least two years. The pharmacy is located inside the Abbotsford Regional Hospital. Remuneration paid according to experience. Please send resumes to info@pharmasaveabby. com, fax 604.870.2955 or please call 604.853.6696. Pharmacy technician – full-time We are presently accepting applications for a full-time registered pharmacy technician. The opening is for Monday to Friday with no evenings or weekends. We offer a very competitive compensation package. Please send resumes to info@pharmasaveabby.com, fax 604.870.2955 or please call 604.853.6696. ARMSTRONG Pharmacist – full-time We are independently owned pharmacies in the North Okanagan region seeking a clinically-orientated pharmacist. Our vision is to have pharmacists completely separate from dispensing functions in order to focus on clinical interventions and follow up with patients. We have great relationships with our patients, local physicians, and other members of the community health care team. We are seeking a pharmacist who is willing to continue to foster and build these relationships. Experience what it's like to work with a team that will fully support you in developing new and creative ways to improve the health of our community while making full use of our growing scope of practice. We offer great hours and a competitive wage and benefit package. Please send resumes to gaarscott@gmail.com. Pharmacy technician – full-time Independent pharmacy in the North Okanagan seeking pharmacy technician. Candidates must be fully registered with the College

of Pharmacists of BC (CPBC). Excellent communication skills and experience with being part of a team is required. We are currently changing our workflow to have a patient-focused pharmacy experience, and we intend to fully implement the scope of practice of a pharmacy technician. To apply, please send resume to armstrongpharmacy@telus.net.

candidate will be a team player with excellent communication skills. Interested applicants are encouraged to send their cover letter and resume to spremji@forewest.ca. Only short-listed candidates will be contacted for interviews.

ASHCROFT

Staff pharmacist required for a busy community pharmacy in Creston, BC. Strong clinical skills (Medication Reviews and injections) are essential. Please send resumes to Jody McBlain, pharmacy manager, at pharmasavecreston@ shaw.ca, fax 250.428.9082 or please call 250.428.9080.

Pharmacist – part-time Excellent career opportunity available at Ashcroft Peoples Drug Mart in the scenic Okanagan. We are looking for a self-motivated, ambitious individual to practice pharmacy in a modern clinical setting. The pharmacy team includes an experienced pharmacy manager, a relief pharmacist, and experienced pharmacy technicians. Ashcroft offers a great mix of clientele, featuring young families and seniors that will allow you to practice all aspects of pharmaceutical care in a retail/clinical setting. Please consider joining Ashcroft Peoples Drug Mart, where pharmacists are committed to helping people live better lives. Competitive wage and benefits. Practice in a modern and fully staffed pharmacy. Hours: Monday to Friday 9am to 5:30pm, Saturday 9:30am to 5pm, closed Sundays and statutory holidays. Please send resumes to vistar69@telus.net, fax 250.453.2404 or call 250.453.2553. BURNS LAKE Pharmacist – full-time We are looking for a full-time pharmacist to join our team and help deliver pharmacy services to our friendly, loyal customers. Pharmacy staff is encouraged to spend time with patients and go beyond the pharmacy counter to use their professional training to its fullest potential. We enjoy giving our customers the best service and at the same time create a pleasant working environment with friendly staff and customers. We offer a competitive wage and benefit package. Relocation assistance is available. License fees to the College of Pharmacists and BCPhA membership fees are included. Please send resumes to lgutenberg@forewest.ca or please call 604.315.3273. CASTLEGAR Pharmacist – full-time Castlegar Pharmasave is currently recruiting for a pharmacist at our busy location. Castlegar is located in the West Kootenay region of British Columbia and is an ideal location for an individual interested in pharmacy practice in a rural setting. Castlegar also provides easy access to numerous outdoor recreation activities. We are looking for a pharmacist that is hard-working, detail-oriented and has excellent clinical knowledge. A pharmacist with injection training and a commitment to providing pharmacy services such as medication reviews and adaptations is required. The ideal

www.bcpharmacy.ca

CRESTON Pharmacist – full-time and part-time

DAWSON CREEK Pharmacy manager – full-time Currently seeking a full-time pharmacy manager or staff pharmacist. If you are a pharmacist who is looking for a great opportunity that provides growth, development and a great work environment then we have the opportunity for you! Excellent compensation and benefits plan, relocation allowance, on-going career development and training programs, opportunity to work with seasoned professionals, participate in our customer clinic day events, annual bonus plan, company stock purchase plan, employee discount program, comprehensive health and dental benefits, employee share ownership plan, and flexible hours with no 24-hour pharmacies in all our locations. We support continuing education and offer various in-house training programs. Please send resumes to kay.sajid@ loblaw.ca, fax 1.866.628.5329 or please call 1.905.216.6010. Pharmacist – full-time Shoppers Drug Mart Dawson Creek is currently recruiting for a pharmacist. Dawson Creek is an ideal location for an individual who is interested in pharmacy practice in a rural setting and who wants to develop real relationships with their patients. As one of the top 15 growing markets in Canada, Dawson Creek has a lot to offer. We are looking for a pharmacist who is hard-working, detail-oriented and has excellent clinical knowledge. A pharmacist with injection training and a commitment to providing pharmacy services such as Medication Reviews and adaptations is required. The ideal candidate will be a team player with excellent communication skills. Interested applicants are encouraged to send their cover letter and resume to Lara Ellis, associate-owner, at asdm216@ shoppersdrugmart.ca or fax 250.782.5593 or please call 250.782.5903. Only short-listed candidates will be contacted for interviews. DELTA Pharmacy technician or assistant – full-time Medical Pharmacy in North Delta is looking for a full-time pharmacy technician/assistant. Job description includes all general pharmacy duties

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including a very busy compounding practice. You would be joining a team of energetic staff working towards a common goal of superior customer service. Store hours are Monday to Friday 9am to 5:30pm, Saturday 9am to 1pm, closed Sunday and all statutory holidays. Please send resumes to deltarx@medicinecentre.com or fax 604.594.4155 or please call 604.594.4499. DUNCAN Pharmacist – part-time Overwaitea Food Group, one of Western Canada’s leading food and consumer-goods retailer, operates over 110 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart Foods, Coopers Foods, Urban Fare and Overwaitea Pharmacy. We provide a very professional pharmacy practice environment and are committed to: challenging & growing our staff, caring for people, healthy living for our shoppers and patients, innovation and investing in our future. Join the Overwaitea Food Group and make your career prescription complete! For more information on career opportunities, please contact or forward your resume in confidence to Gary Go, B.Sc. (Pharm.), R.Ph., regional manager, pharmacy operations, at gary_go@owfg.com. FORT NELSON

intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industries finest. Learn more about what we have to offer. Please send resumes to pharmacyemployment@owfg.com.

LANGLEY

KAMLOOPS

Pharmacist – part-time

Pharmacist – part-time

Pharmasave #003 is looking for a part-time pharmacist to cover a maternity leave position. We are looking for a pharmacist that is proficient with WinRx, has injection training, and is committed to performing Medication Reviews and other Rx services such as adaptations. We prefer a pharmacist with at least one year of experience and familiarity with nursing homes. For more information, please send your cover letter and resume to Sameer Premji, pharmacy operations coordinator, at spremji@forewest.ca.

London Drugs has a part-time opportunity in Kamloops. Join a clinical and patient focused team using the latest robotic dispensing machines plus counseling booths and counseling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, Rx operations manager, at ssangha@londondrugs.com or fax 604.448.1075.

Pharmacist – full-time

KELOWNA

Position available immediately. Are you a pharmacist with an enthusiasm for the outdoors? Want to work in a location that promises incredible scenery? Unforgettable encounters? Our store is seeking a highly motivated and enthusiastic individual to become a part of our team. This position offers a very comprehensive compensation package and a flexible 40 hour work week (no evenings, Sundays or statutory holidays). View the full job description online at www.bcpharmacy.ca/jobs. Please send resumes to Duane Knott, owner, at fortnelsonida@hotmail.com, fax 250.774.2326 or please call 250.774.2323.

Pharmacy technician – full-time

GIBSONS Pharmacist – part-time London Drugs has a part-time opportunity in Gibsons. Join a clinical and patient focused team using the latest robotic dispensing machines plus counseling booths and counseling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, Rx operations manager, at ssangha@ londondrugs.com or fax 604.448.1075.

Pharmacist – full-time The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 80 pharmacies across BC and Alberta. We’re a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just

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KIMBERLEY Pharmacy technician – full-time We are a growing compounding pharmacy with new services in long-term care. Preference will be given to a pharmacy technician or assistant with relevant work experience in long-term care. This position will require attention to detail and exceptional organizational skills. Currently we are Monday to Friday 9:30am to 6pm; with possible expansion into shortened Saturday hours. Kimberley is an amazing mountain town with all the outdoor living activities you could dream of at your fingertips. This position starts immediately. Wage negotiable upon experience. Please send resumes to Michelle Gray, pharmacist/owner, at pharmacist@ grayspharmacy.ca, fax 250.427.0039 or please call 250.427.0038. Pharmacy assistant – full-time

GRAND FORKS

26

The role of the pharmacy technician is to aid the pharmacy in the production of prescriptions and provide optimal customer service. Participate actively in growing prescription and OTC sales. Candidates must have registered pharmacy technician certification and maintain registration with CPBC. Please send resumes to kay.sajid@ loblaw.ca, fax 1.866.628.5329 or please call 1.905.216.6010.

Jun/Jul 2014

We have a summer student position to either a pharmacy student or pharmacy technician student. Duties would include assisting in all aspects of operation from receiving front store and pharmacy inventory, to blister packing, compounding, promoting services around the community. Please send resume by email to grayspharmacy@ remedysrx.ca or please call 250.427.0038.

www.bcpharmacy.ca

Pharmacist – full-time Full time pharmacist required for independent community pharmacy. Store is located in a medical building. Applicant to be licensed in BC and injection certified. Various duties include Medication Reviews, injections, checking and counseling patients of prescriptions and OTCs. Compounding skills a plus. Must be able to work Saturdays. Store closed evenings, Sundays and statutory holidays. Competitive salary and benefits. Come be part of the team. Please send resumes to valphar@hotmail.com.

NANAIMO Pharmacist – part-time London Drugs has a part-time opportunity in Nanaimo. Join a clinical and patient focused team using the latest robotic dispensing machines plus counselling booths and counselling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, Rx operations manager, at ssangha@londondrugs.com or fax 604.448.1075. OSOYOOS Pharmacist – full-time Pharmasave, Canada’s most successful retail program for independent drugstores, is accepting applications for a full-time pharmacist in the beautiful South Okanagan. We are looking for a pharmacist to provide excellent clinical services and care for our clients. Injection training and experience with Medication Reviews and knowledge of Kroll software would be an asset. If you enjoy working in a team environment, performing superior customer service, and are self-motivated, please apply by email to psosoyoos@pharmasave011.com. Pharmacy technician or assistant – full-time Pharmasave, Canada’s most successful retail program for independent drugstores, is accepting applications for a pharmacy assistant or registered pharmacy technician. Responsibilities include: customer service, all aspects of preparing medication orders, compounding, nursing home, general housekeeping in the department, and inventory management. This position is full-time for a term of 15 months to cover a maternity leave. If you enjoy working in a team environment,


performing superior customer service, and are self-motivated, please email your application to psosoyoos@pharmasave011.com. PENTICTON Pharmacist – part-time London Drugs has a part-time opportunity in Penticton. Join a clinical and patient focused team using the latest robotic dispensing machines plus counselling booths and counselling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, Rx operations manager, at ssangha@londondrugs.com or fax 604.448.1075. PORT ALBERNI Pharmacy manager – full-time Overwaitea Food Group, a Canadian owned company, is one of Western Canada’s leading food and consumer-goods retailer and operates more than 100 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart Foods, Coopers Foods, Urban Fare and Overwaitea. We provide a very professional pharmacy practice environment and are committed to: challenging & growing our staff, caring for people, healthy living for our shoppers and patients, innovation, and investing in our future. Applicants must have a BC license and be in good standing with the College of Pharmacists. Good communication skills and knowledge of Kroll software are considered an asset. Please forward your resume in confidence to Sammy Lee, regional manager, pharmacy operations, at sammy_lee@owfg.com. Sorry but only short-listed applicants will be contacted. PRINCE GEORGE Pharmacist – full-time London Drugs has a full-time opportunity in Prince George. Join a clinical and patient focused team using the latest robotic dispensing machines plus counseling booths and counseling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, pharmacy operations manager, at ssangha@londondrugs.com or fax 604.448.1075. RICHMOND Pharmacy technician – full-time A well-established community pharmacy is seeking an experienced licensed pharmacy technician who is motivated to learn and succeed. Must have two years prior work experience, ability to work in a high volume pharmacy, possess strong organizational, problem solving and communication skills, excellent customer service, proficient computer/ data entry skills, and be familiar with dispensing,

ordering, inventory management, etc. Responsibilities include: data entry of patient care information into Applied Robotics (Rx Software System), third party adjudication if necessary, accurate dispensing of medications, maintenance of pharmacy stock through inventory control, blister packaging, front shop & home health care sales (mobility aids, bathroom safety, compression stockings, braces/supports, etc.). Please send resumes to ardatoo1@yahoo.ca. SALMON ARM Pharmacist – full-time The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 80 pharmacies across BC and Alberta. We’re a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industries finest. Learn more about what we have to offer. Please send resumes to pharmacyemployment@owfg.com. SALT SPRING ISLAND Pharmacist – full-time Pharmasave on Salt Spring Island has an opening for a full-time pharmacist. If you dream about living in one of the most vibrant and beautiful Gulf Island communities in BC while still maintaining an interesting and rewarding career, then you should consider joining our team of experienced and dedicated professionals. We offer a competitive compensation and benefits package and the opportunity for a truly great lifestyle. Our standards are high and we aim to offer our customers the best service and pharmacy counseling available. Come and find out why The New York Times calls Salt Spring Island one of the "gems" of the Pacific Northwest. Please send resumes to gary@saltspringpharmasave.com or please call 250.537.5534. SURREY Pharmacy manager – full-time Pharmacy Manager needed for independent community pharmacy. Friendly environment. We offer a competitive wage. Must be able to work some weekends. Please send resumes via fax to 604.543.4433 or please call 604.543.6677. Pharmacy technician – full-time Immediate opening for a pharmacy technician. Previous experience an asset and applicant must possess excellent communication skills. Please send resumes to Nafisa, pharmacist/manager at nafisam@telus.net or fax 604.325.3276.

www.bcpharmacy.ca

Pharmacy technician – full-time Medical Pharmacies has an exciting opportunity in a specialized long-term care setting. The right candidate will embrace our leading technology and clinical services, be innovative in their approach to providing excellent care, and be licensed with the College of Pharmacists of BC. Long-term care experience is an asset, but not necessary. Great potential for career advancement. Responsibilities include institutional dispensing, checking orders, data entry, compliance packaging and compounding. Please send resumes to Curtis Fieseler, regional director of operations, at cfieseler@ medicalpharmacies.com or fax 250.717.1565 or please call 250.317.6823. VANCOUVER Pharmacist – full-time We are looking for full-time pharmacists for our Lower Mainland pharmacy. Experience with WinRX/Kroll and Microsoft Office (Word, Excel, etc.) are necessary. The successful applicant is required to have at least one to two years of experience working in a community pharmacy and to be injection certified. Pharmacists must also have a good working knowledge of PharmaCare and third party billing policies, knowledge of Medication Reviews, and experience with blister packing. Pharmacists must be strong communicators, clinically oriented, and willing to further their pharmacy practice and patient-centered care. Wages start at $37/hour and increases steadily with experience. Full medical and dental benefits are provided after a trial period of three months. Please send resumes to shafik@ wescanapharmacy.com. Pharmacist – full-time We are a well-established, fast-paced independent community pharmacy currently looking for a motivated, focused and diligent full-time pharmacist to join our expanding team. We are a dynamic, clinical-based dispensary who works with multidisciplinary healthcare professionals to provide excellent customer service and quality patient focused care. Successful candidates must be registered and in good standing with CPBC, possess strong and effective communication and organizational skills, and the ability to work effectively in a team environment as well as independently. Experience with adaptations, administering injections and Med Reviews an asset. No evenings. Position to start immediately. If interested, please send in a cover letter and your resume to vancouverpharma@gmail.com. New grads are welcome to apply. Pharmacist – full-time or part-time We are looking for a full-time or part-time pharmacist for our Vancouver location. Fluency in Punjabi/Hindi would be an asset. We are part of a clinic with a family practice. Normal medication dispensing duties with a focus on medication management and building close relationships with patients. Our hours are 10am to 6pm – Monday to Friday, 10am to 4pm Saturday. We are an innovative and progressive

Jun/Jul 2014

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pharmacy. Potential business opportunities for a creative pharmacist. Please send resumes to hr@cloudpharmacy.ca, apply online at www. cloudpharmacy.ca or please call 1.877.331.4411. Pharmacist – part-time Part-time pharmacist position available, experienced in retail pharmacy, exceptional communication and organization skills, familiar with Telus RxA or RxT program, and able to work productively as a member of a dynamic team. If required, willing to work at two different pharmacy locations, both in the Lower Mainland. Please, no phone calls about this job. Please send resumes to ymm@yyoung.com or fax 604.630.1001. Pharmacist – part-time Part-time pharmacist needed for an independent pharmacy in Vancouver. Flexible schedule - no evenings and Sundays. Cantonese speaking would be an asset. If interested, please call 604.683.6381 or send resume by email to mlrx506@gmail.com. Pharmacy technician – full-time Regulated technician position available. Medical Pharmacies has an exciting opportunity in a specialized long-term care setting. The right candidate will embrace our leading technology and clinical services; be innovative in their approach to providing excellent care to the residents we provide for and be licensed with the College of Pharmacists of BC. Long-term care experience is an asset, but not necessary. Great potential for career advancement. Responsibilities include institutional dispensing; checking orders, data entry, compliance packaging, compounding. Please send resumes to Curtis Fieseler, regional director of operations, at cfieseler@medicalpharmacies.com or fax 250.717.1565 or please call 250.317.6823. Pharmacy technician – full-time Immediate opening for a pharmacy technician. Previous experience an asset and applicant must possess excellent communication skills. Please send resumes to Nafisa, pharmacist/manager at nafisam@telus.net or fax 604.325.3276.

Pharmacy assistant – full-time or part-time

Pharmacist – full-time

We are looking for full-time or part-time pharmacy assistants. Fluency in Punjabi/ Hindi would be an asset. Knowledge regarding PharmaCare and other third-party special authority processing is considered a major asset. Duties include: normal entry and filling using Kroll software, blister packing and inventory management. Our hours are 10am to 6pm Monday to Friday, 10am to 4pm - Saturday. We are a new, innovative pharmacy looking for creative individuals. Please send resumes to hr@cloudpharmacy.ca or apply online at www. cloudpharmacy.ca or please call 1.877.331.4411.

We are seeking a full-time pharmacist to join our Peoples Drug Mart location in Victoria, BC. Our store has an elderly population base and is located adjacent to physicians’ offices and walkin medical clinics. We are seeking the following skills: ability to work collaboratively with physicians and staff; ability to counsel patients on the use of OTCs; ability to perform Medication Reviews; and ability to communicate effectively with elderly patients. Candidates with injections authority are encouraged to apply. Please send resumes to sunil@sparklit.com or please call 250.818.1468.

VERNON Pharmacy manager – full-time If you are a pharmacist who is looking for a great opportunity that provides growth, development and a great work environment then we have the opportunity for you! Excellent compensation and benefits plan, relocation allowance, on-going career development and training programs, opportunity to work with seasoned professionals, participate in our customer clinic day events, annual bonus plan, company stock purchase plan, employee discount program, comprehensive health and dental benefits, employee share ownership plan, and flexible hours with no 24-hour pharmacies in all our locations. We support continuing education and offer various in-house training programs. Please send resumes to kay.sajid@loblaw.ca, fax 1.866.628.5329 or please call 1.905.216.6010. Pharmacy technician – full-time The role of the pharmacy technician is to aid the pharmacy in the production of prescriptions and provide optimal customer service. Participate actively in growing prescription and OTC sales. Candidates must have registered pharmacy technician certification and maintain registration with CPBC. Please send resumes to kay.sajid@ loblaw.ca, fax 1.866.628.5329 or please call 1.905.216.6010. VICTORIA

Pharmacy technician – full-time

Pharmacy manager – full-time

Pharmasave at Broadway and Commercial has an immediate opening for a registered technician. We are a community pharmacy open six days a week (9am to 5:30pm) and closed on Sundays and holidays. We offer a competitive wage and benefit package. If interested, please send resume by email or fax to Alan in confidence at ps214@shaw.ca or fax 604.926.6052.

The pharmacy manager is responsible for managing store pharmacy operations and maintaining a professional and cohesive working relationship with the front store manager and staff. They are a catalyst in the execution of a superior patient care experience that translates into an environment that ensures people make the healthiest choices quickly, easily and confidently. Qualifications: BC pharmacy license; experience in retail pharmaceutical systems and dispensing procedures (e.g., Nexxsys); ability to maintain optimum balance between the profession and business of pharmacy; strong financial acumen; excellent communication and organizational skills; strong patient satisfaction orientation, leadership and decision-making skills; previous pharmacy management experience (preferred). Please send resumes to Neerav Joshi, talent acquisition specialist, at njoshi@rexall.ca or apply online at www. rexallcareers.ca.

Pharmacy technician or assistant – full-time We are looking for full-time pharmacy assistants or registered pharmacy technicians for our Lower Mainland pharmacy. Experience with WinRX and Microsoft Office (Word, Excel, etc.) are assets. Start date is immediate upon hiring. Compensation is between $12-18 depending on the applicant’s experience. Medical and dental benefits are provided after a trial period of three months. If interested, kindly send a resume and cover letter to shafik@wescanapharmacy.com.

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Jun/Jul 2014

www.bcpharmacy.ca

Pharmacist – full-time Are you looking for an opportunity with an established independent pharmacy chain that is looking to grow and expand its focus on patient care, and clinical specialization? We take patient follow up to a whole new level. We are looking for energetic pharmacists who want to practice their full scope of clinical skills and help us bring top-notch health care to our customers. Victoria Peoples Pharmacies owned by Naz Rayani are looking for an engaged, clinically oriented and outgoing full-time pharmacist to work at our unique community pharmacies. Please send resumes to jobs@victoriapharmacy.com. Pharmacist – full-time Dedication to the health and well-being of our customers and patients is at the core of our business. We offer excellent base salary rates, annual bonus opportunities, full benefits package, educational allowance, paid med checks and career growth opportunities. Qualifications: pharmacy license to practice in BC, experience in retail pharmaceutical systems and dispensing procedures, exceptional communications and organizational skills, strong patient satisfaction orientation, ability to maintain optimum balance between the profession and business of pharmacy, strong problem solving and analytical skills, and the ability to work productively as part of a dynamic, fast-paced team. Please send resumes via email to Neerav Joshi, talent acquisition specialist, at njoshi@rexall.ca or apply online at www.rexallcareers.ca. Pharmacist – full-time We are now hiring a dedicated and dynamic pharmacist to join our team in Victoria, BC. At Remedy’sRx Specialty Pharmacy, we service long-term care, retirement homes and group homes through our dedicated pharmacy. Specialty pharmacy provides opportunities to work in inter-professional teams, and a patientfocused practice environment that allows pharmacists to thrive. This full-time position requires minimal evenings and weekends, and we offer a competitive wage and benefit package. If you would like to become a member of a national pharmacy company with exceptional growth potential, please apply to Enna Aujla, regional director of operations, at enna@remedys.ca. Pharmacist – part-time Locally-owned independent IDA pharmacy located in downtown Victoria is looking for a young energetic pharmacist that is outgoing


and eager to learn. Current shifts available are Sundays or Saturdays from 9am to 5pm. This has potential to become a fulltime position. Please call Jason directly at 250.634.0623 or email your resume to jason@ cridgefamilypharmacy.com. Pharmacy technician – full-time Pharmacy technician required to work at Victoria Peoples Pharmacy, owned and operated by Naz Rayani. Our focus is on patient-centered practice with a desirable and friendly population. All applications are confidential. Compensation is commensurate with experience. Please send resumes to jobs@victoriapharmacy.com. Pharmacy technician – full-time Elements Compounding Pharmacy has an immediate opening for a full-time regulated pharmacy technician. The individual should have a minimum of two years work experience in a retail pharmacy environment. We are looking for a highly-motivated, career-minded individual to join our team. Experience working in a compounding pharmacy as well as using Kroll would be an asset. Please submit your resume, including cover letter and references, in person or via email to info@elementspharmacy.ca. Fax 250.590.6778 or phone 250.590.6777. Pharmacy technician – full-time Victoria Rexall has an immediate opening for full-time pharmacy technician. We offer a very competitive compensation package. Please send resumes to njoshi@rexall.ca or apply online at www.rexallcareers.ca. WEST VANCOUVER Pharmacist – part-time Pharmasave, located in The Village at Park Royal, West Vancouver, is seeking a BC licensed pharmacist for one Saturday shift every four weeks beginning August 2014. We offer competitive compensation and an excellent work environment. The goal of our pharmacies is to become an integral part of the community by focusing on patient care and building relationships with area healthcare providers. It is essential that candidates possess strong interpersonal skills and have a commitment to providing exceptional customer service in a team environment. Please send resumes to pharmacist@prvpharmasave.com.

OPPORTUNITIES ACROSS BC

OPPORTUNITIES OUTSIDE BC

Pharmacist – full-time

Fort McMurray, AB

The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 80 pharmacies across BC and Alberta. We’re a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industries finest. Learn more about what we have to offer. Please send resumes to pharmacyemployment@owfg.com.

Pharmacist – full-time

Pharmacy technician – full-time Float position available. Medical Pharmacies has an exciting opportunity in a specialized longterm care setting. This position is unique and will give the successful candidate the opportunity to gain experience in our pharmacies located in Surrey, Vancouver, and to a lesser extent Kelowna. The right candidate will embrace our leading technology and clinical services and must be licensed with the College of Pharmacists of BC. Good communication skills and being a strong team player are required. Long-term care experience is an asset, but not necessary. Great potential for career advancement. Responsibilities include institutional dispensing; checking orders, data entry, and other dispensing tasks. Please send resumes to Curtis Fieseler, regional director of operations, at cfieseler@medicalpharmacies.com or fax 250.717.1565 or please call 250.317.6823.

The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 80 pharmacies across BC and Alberta. We’re a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industries finest. Learn more about what we have to offer. Please send resumes to pharmacyemployment@owfg.com. Lethbridge, AB Pharmacist – full-time The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 80 pharmacies across BC and Alberta. We’re a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industries finest. Learn more about what we have to offer. Please send resumes to pharmacyemployment@owfg.com. Red Deer, AB Pharmacist – full-time The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 80 pharmacies across BC and Alberta. We’re a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industries finest. Learn more about what we have to offer. Please send resumes to pharmacyemployment@owfg.com.

www.bcpharmacy.ca

Jun/Jul 2014

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BUSINESS OPPORTUNITIES

Unlike other banners, Peoples Drug Mart does not charge a percentage of sales. Our belief is that the profits from your hard work should stay in your business. With Peoples, you get the best of both worlds, outstanding support and services, and the ability to maintain your profits. If you are interested in purchasing, selling or opening a new pharmacy, please contact Frank Fidyk at fgfidyk@telus.net or please call 778.678.6717.

WHAT IS IMPORTANT TO YOU IS IMPORTANT TO US. PHARMASAVE is the best choice for independent business in BC. Maintain your freedom while having access to the most comprehensive retail and professional programs in the industry and our strong national brand. We are a true cooperative, 100% memberowned and governed. Benefit from owning your own business and also share in the economic advantages of a strong group of over 500 stores. Be an owner in an organization that delivers all of its profits directly back to you, the shareholder. If you are a store owner and would like to consider opportunities with Pharmasave, or a pharmacist interested in purchasing a pharmacy, or are planning on selling your business, please give us a call. Our only priority is you and your success! Contact Dave Reston, CEO, Pharmasave Pacific, phone 604.575.5730 or 1.800.665.3344, email dreston@pharmasavebc.ca.

Rewarding ownership opportunity – Surrey Enjoy the best of both worlds and be in business for yourself instead of by yourself. Unique business opportunity for the right person. Seeking a pharmacist/partner for Surrey, BC area. Please call 604.543.6677 to learn more. Partnership – Vancouver Currently operating a busy pharmacy with large blister pack clientele. Would like to collaborate with other business owners and expand. We have a strong IT and construction team looking for opportunities. Please send resumes to hr@ cloudpharmacy.ca or please call 1.877.331.4411.

Are you thinking of selling your pharmacy? OVERWAITEA FOOD GROUP may be interested. If you would like more information please contact us via email at pharmacybuyer1@gmail.com.

Pharmacist (General) members: Yesir Al-Sharbati, Stephen Alexander, Waeel Ameen, Amr Ammar, Daniel Berg, Shafreen Bhanji, Gillian Blaine, Lee Boyer, Emily Chow, Helen Chow, Rose Colp, Harikrishna Dasani, Robert Dilfer, Jordan Ducheminsky, Curt Fowkes, Ryan Fung, Nancy Gallagher, Pranavkumar Gandhi, Marina Gerges, Harmandeep Gill, Bijalbharthi Goswami, Kyungjoo Han, Melissa Haynes, Glenn Hori, Shannon Huyber, Hassan Ibrahim, Tariq Ijaz, Mathew Jacob, Barry Jay, Rupinder Kahlon, Vivek Kamdar, Rosemin Kassam, Samuel Kates, Jayeshkumar Khunt, Dominika Kincer, Magdalena KowalskaVillarroel, Davie Lam, Trent Lane, Tammy Langill, Manuel Lara, Thomas Lebbetter, Diane Lee Van On, Da Weon Lee, Andrew Lowe, Satwinder Mann, Lyla Massicotte, James McCormack, Nathan McLean, Heather McLennan, Emad Mohamed, Keya Morasse, Erini Mousa, Umar Muhammed, Nadia Mumtaz, Tommy Jun Qing Pan, Parmjeet Panesar, Andrii Panshyn, Bhavinkumar Parikh, Hardik Parmar, Nikunj Patel, Silvia Poelstra Porra, Heejin Ra, Janet Reeves, Daryl Regier, Simon Sandhu, John Schulmeister, Ronak Shah, Mostafa Shahin, Aftab Shaikh, Mark Sheppard, Jacqueline Smith, Maral Sobhanipoor, Stella Jonghee Song, Ashley Turner, Umeshkuma Vaishnav, Jaspreet Virdi, Bala Vitta, Susanna Wong, Katherine Xu, Paul Yip, and Elizabeth Zhang

Pharmacy (Corporate) members: Cooper's Foods Pharmacy #150 – East Abbotsford, Mary's Pharmacy, Pharmasave Health Centre #091 Newton, Rexall Reid's Prescriptions #7175, Save-On-Foods Pharmacy #909 – Port Alberni, Save-On-Foods Pharmacy #916 – Sapperton, Save-on-Foods Pharmacy #919 – Royal City, Save-OnFoods Pharmacy #923 – Tillicum, Save-On-Foods Pharmacy #924 – Shelbourne, SaveOn-Foods Pharmacy #933 – Duncan, Save-on-Foods Pharmacy #943 – Tsawwassen, and Target Pharmacy #T-3512

Jun/Jul 2014

Cyril Lopez Chief Operating Officer 604.269.2869 cyril.lopez@bcpharmacy.ca Derek Desrosiers Director, Pharmacy Practice Support 604.269.2862 derek.desrosiers@bcpharmacy.ca Kathie Taylor Director, Communications 604.269.2863 kathie.taylor@bcpharmacy.ca Letlotlo “Coco” Lefoka Manager, Public Affairs 604.269.2868 coco.lefoka@bcpharmacy.ca Vince Lee Manager, Marketing 604.269.2867 vince.lee@bcpharmacy.ca

Elise Riedlinger Manager, Communications 604.269.2866 elise.riedlinger@bcpharmacy.ca

Welcome to the BCPhA!

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Geraldine Vance Chief Executive Officer 604.269.2860 geraldine.vance@bcpharmacy.ca

Bryce Wong Manager, Pharmacy Practice Support 604.269.2865 bryce.wong@bcpharmacy.ca

PEOPLES DRUG MART is an established and proven pharmacy banner that will make your pharmacy business more successful and profitable. We provide outstanding marketing support and services for a low monthly fee.

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ASSOCIATION CONTACTS

www.bcpharmacy.ca

Nelson Chen Coordinator, Pharmacy Practice Support 604.269.2880 nelson.chen@bcpharmacy.ca Ray Chow Database Administrator, Member & Corporate Services 604.269.2882 ray.chow@bcpharmacy.ca Maria dela Cruz Executive Assistant & Project Coordinator 604.269.2861 maria.delacruz@bcpharmacy.ca Linda Tinnion Assistant, Member Services 604.269.2864 linda.tinnion@bcpharmacy.ca Starr Rempel Administrative Assistant Member & Corporate Services 604.261.2092 starr.rempel@bcpharmacy.ca 604.261.2092, Toll-free: 1.800.663.2840 info@bcpharmacy


BC Lions Canucks Car rental Cineplex Hotels around the world PNE and Playland Show tickets and much more!

Affinity BCPhA prescribed member discounts

Save $5 to $10 on all ticket types Contact Hermon Tesfaghebriel 604.930.5452 hermont@bclions.com

15 - 30% off retail price

Movie tickets

Affinity Rx price per ticket $8.50 ($8.92 after GST)

Regular price per ticket $11.99

2-year rate plans Up to $250 back in cash and credit.

Unlimited Canada-wide calling Unlimited text, picture and video messaging $55, $65, $75 plans and much more.

Save $14 to $37 on all ticket types Contact Jamieson Brooks 604.484.7867 jbrooks@whitecapsfc.com

Hotels around the world 10 - 15% cheaper than any other booking website on average

Big Savings Across the United States! Events, shows and restaurants

More offers BC Lions tickets Car purchase Canucks tickets Clearlycontacts.ca Events, shows, restaurants

PNE and Playland events Real estate services Retail Subscriptions and more new offers coming...

HOW TO ACCESS THE DEALS Log into www.bcpharmacy.ca and go to the Member Support - Affinity Rx section or email vince.lee@bcpharmacy.ca


Special thanks to this year’s sponsors! Partner

Diamond

Platinum

Gold

Silver

at

Bronze

Thank you to the exhibitors at the 2014 conference Exhibitors: Adams Cambie Insurance Ltd., Almirall Limited, Bayer Inc., BC Drug and Poison Information Centre, Beiersdorf Canada Inc., Bio-K+ International Inc., College of Pharmacists of British Columbia, Desante Financial, Galenova, Green Shield Canada, HealthTab, Heel Canada Inc., Hydralyte Canada, Jamp Pharma Corporation, Janssen Inc., Johnson & Johnson Consumer Healthcare, Johnstone’s Benefits Inc., LifeScan Canada Ltd., Kohl & Frisch Ltd., Lundbeck Canada, Mallinckrodt Pharmaceuticals, McKesson APS, Medical Futures Inc., MEDISCA, Merck, Novartis Pharmaceuticals Canada, Pacific Blue Cross, Pascoe Canada, PCCA Canada, Pendopharm - division of Pharmascience Inc., Roxon Medi-Tech, Scotiabank, Sanofi Pasteur Ltd., Takeda Canada Inc., TELUS Health, Trudell Medical International, Valeant Canada, Wynward Insurance Group, Xenex Laboratories Inc.


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