Crohn’s and Colitis Awareness • Movember • Treating Minor Ailments in Saskatchewan
tablet
published by the British Columbia Pharmacy Association | www.bcpharmacy.ca | Volume 21. No. 5
OCT/NOV 2012
Welcome
to the new Faculty of Pharmaceutical Sciences building at UBC
Boost your career! As part of our pledge to support our members’ expanded scope of practice, BC Pharmacy Association aims to have at least one pharmacist in every pharmacy in BC authorized to administer injections. Isn’t it time you were trained to inject? Administration of Injections Program practical workshops have been scheduled for October and November. Go to www.bcpharmacy.ca to register today.
THE TABLET
OCT/NOV
2012 | VOLUME 21. NO.5
contents Editor-in-Chief Kathie Taylor 604.269.2863, kathie.taylor@bcpharmacy.ca
16 on the cover
Senior Editor Elise Riedlinger 604.269.2866, elise.riedlinger@bcpharmacy.ca Advertising Sales Heather Sell, OnTrack Media 604.639.7763, tablet@ontrackco.com 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.
12 breast cancer
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
24 DPIC
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Cover Photo: Dean Robert Sindelar and Minister of State for Seniors Ralph Sultan explore the Story of Medicines.
Features 16
Columns
Regulars
Cover Article: New Faculty of Pharmaceutical Sciences Building
6
President’s Message The challenge ahead
5
Meet the Board Ralph Lai
7
CEO’s Message Uncertainty continues
24
DPIC Osteoporosis
UBC Update
8
Professional Services Are you ready for the flu season?
26
Skin Care Pharmacy Synthetic skin substitutes
9
Member Services Make the most of your benefits
28
Career Listings Find a job in pharmacy
14
Clinicare Pharmacists Complex Regional Pain Syndrome
20
Student News A new year and new home
10
Movember A phar-mo-cist gives back
12
Breast Cancer Awareness Dyck’s Pharmacists run for the cure
18
White Coat Ceremony An annual tradition
21
Minor Ailments Saskatchewan authority
22
Get Gutsy Crohn’s and colitis
Got a suggestion for an article in The Tablet? Email info@bcpharmacy.ca with your story ideas.
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Oct/Nov 2012
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SMALL TALK
In the news Annual General Meeting BCPhA’s AGM will be held on Saturday, November 17, 2012, at the Morris J. Wosk Centre for Dialogue in Vancouver. The AGM is jointly hosted by the College of Pharmacists of BC. For more information, please contact Emilija Stanic at 604-269-2861 or emilija.stanic@bcpharmacy.ca.
BC now requires health care workers to get flu shot or wear masks On August 23, 2012, BC’s Provincial Health Officer Dr. Perry Kendall announced new regulations requiring BC health care workers who come into contact with patients at health care facilities, within the community, and at long-term care homes to receive the annual influenza vaccine. If unable or unwilling, they will be required to wear a surgical mask at work for the duration of the flu season.
BCPhA staff members Cyril Lopez, Linda Tinnion, Bryce Wong and Elise Riedlinger joined this year’s diverse group of students in UBC’s Canadian Pharmacy Practice Program. The program prepares international pharmacy grads for practice in Canada, and Canadian-trained pharmacists to re-enter practice in BC.
This policy applies only to health care employees employed by the health authorities or other health care workers, staff, students or volunteers who attend a patient care location.
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MEET THE BOARD
Meet…Ralph Lai The stronger our membership, the more credible voice we have in representing pharmacists and pharmacies. This is extremely important when we’re talking with government, industry, health care providers and other stakeholders. What do you enjoy most about your current position with Overwaitea Food Group?
Ralph Lai graduated from the UBC Faculty of Pharmaceutical Sciences in 1981, and began his career working for an independent community pharmacy. He worked in other community pharmacy settings before joining Overwaitea Food Group (OFG) in 1985 – the same year he earned his MBA from UBC – and is now OFG’s general manager, pharmacies. Ralph was on the BCPhA Board of Directors for two consecutive terms from 2001 to 2007, and was elected to the Board again in 2010. He was elected president in September of this year. Why should the Association matter to pharmacists in BC? The BCPhA is the voice for pharmacy in our province, and can advocate for various issues that are important to our industry. BCPhA will continue to move the profession forward. While the College has the mandate to protect the public, our Association looks after the professional role and economic interest of our members.
As the general manager, pharmacies, I’m basically responsible for everything pharmacyrelated: strategically, operationally, etc. Therefore I know I can make a difference in terms of professional practice, as well as the profitability of my division in the company. What’s most gratifying is having our plans come to fruition with pharmacists, such as the training needed to expand scope of practice. For example, Overwaitea was one of the first to partner with BCPhA when injections training began in 2009. We made up a significant percentage of authorized pharmacists in the first year alone. What do you consider your biggest accomplishment so far? I’m the most proud of having a harmonious family, and a great spouse who supports me. If you weren’t a pharmacist, what would you be? I would be a golf pro at the PGA, but I lack the talent! I would also be in the technology field, as I enjoy playing with gadgets. Being a pharmacist has been an extremely rewarding and worthwhile career. We can make a difference in the everyday life of people, in improving their health care.
What’s the biggest change you’ve seen in pharmacy since graduating in 1981? We’ve certainly seen more aggressive government policies in the past several years, in terms of both policy and control, especially cost control. The business and practice of pharmacy have increased in complexity. On a positive note, we’ve also seen a vast expansion of our scope of practice, and will hopefully continue to see this expansion enhance our role in the primary health care team. Where would you like pharmacy to go next? As I mention briefly in my column, I’d like to see pharmacists in BC have an expanded and established role in primary care. Pharmacists should be able to help government save on health care costs, because we’re on the frontline and are able to positively impact so many people compared to other health professionals. I’m not advocating taking over the role of physicians or other clinical experts, but we want to compliment and supplement these roles, such as responding to a minor ailment before it requires more complex care and therefore more dollars from the health care system. I’d like to see pharmacists continue to expand their scope, and be reasonably paid for these services. Do you have any hidden talents? I love to eat – I think I could be a restaurant critic. Maybe I’ll even become a blogger one day and get paid for it.
Board of Directors Shakeel Bhatti, Langley (604) 534-6605, shakeelbhatti@shaw.ca
Julie Ford, Kamloops (250) 318-1371, julieford@shaw.ca
Allison Nourse, Vancouver (604) 276-5280, allisonn@unipharm.com
Bill Bright, Calgary (403) 663-8793, b.bright@telus.net
Caren Heughan, Victoria (250) 388-5181, carenheughan@gmail.com
David Pavan, Vancouver (604) 301-2620, david.pavan@gmail.com
Don Cocar, Kelowna (250) 808-1308, don@dycksdrugs.com
Victor Ikari, Ashcroft (250) 453-2553, pdm72@pdmstores.com
Greg Shepherd, Vancouver (604) 317-9608, gshepherd@pharmasavebc.ca
Derek Desrosiers, Richmond (604) 276-5236, derekd@unipharm.com
Ralph Lai, Langley (604) 881-3882, ralph_lai@owfg.com
Nadeem Zia, Surrey (604) 585-5666, nadeem.family.pharmacist@gmail.com
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Oct/Nov 2012
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RALPH LAI | PRESIDENT
The challenge ahead I would like to start my term
evolve, improve our skills and update our practices to include new services that involve us in primary health care.
as the president of the BCPhA by recognizing the leadership and contribution of our past president, Greg Shepherd. Thank you, Greg, for your hours of work representing our Association. As I reflect on the speech made by Adrian Dix at the Vancouver Board of Trade luncheon on September 18th, and the various decisions made by the provincial government affecting our industry, I can only conclude that we do not have many decision makers in the political arena who understand the work and value of pharmacists. We are experiencing tremendous change, and much of it is driven by government drug reform that is currently targeting the pricing and incentives of generic drugs.
“Our expanded scope of practice will need to be embraced”
Prescription medication is one of the major cost drivers of the provincial budget. The economic forecast for community pharmacy from Bill 35 shows a major sustainability problem in the current pharmacy model. In the majority of pharmacies, the cost for dispensing medication is much higher than the dispensing fee that is charged. We have relied on the professional allowances provided to us by the generic manufacturers to make up the cost gap from the low dispensing fee. With the continued drive for generic cost savings from the government, and a similar policy from the opposition, we will have to change our practice model. I just hope that the price deflation of generic medications will not create drug supply and other issues that ultimately will affect the health of British Columbians. The economic reality is that pharmacy owners will decrease the cost of dispensing by increasing the use of pharmacy assistants and pharmacy technicians. Pharmacists, like me, will have to
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Our expanded scope of practice will need to be embraced by many of us to create a critical mass. All of us need to offer new services like injections and medication management – and perhaps in the near future, our scope will also include minor ailment prescribing. The more relevant services the public experiences from us, the better our profession can establish our position for primary care and the funding that must go with it.
Our Association will continue to advocate for its members and to represent community pharmacy. We will continue to lobby and communicate with our government to set reasonable drug prices, especially for generics, and to allow the free market to determine commercial terms and incentives. The value of pharmacists, and our legitimacy as contributing members of the primary health care team, needs to be communicated to government, private insurers, other health care providers, media and the public. Collaboration with the College, drug manufacturers, academia and other stakeholders will help solidify our support for establishing our place in primary health care with sustainable funding. In conclusion, I am fortunate to be working with an experienced Board and a talented team led by Geraldine Vance. We will make a difference for sustainability for community pharmacy, professionally and economically.
GERALDINE VANCE | CEO
Uncertainty continues to be the name of the game Despite the many years since I was a
student, September always marks a new year, a time of new beginnings. At the BCPhA this is accentuated by the fact that it is the beginning of our new fiscal and political year. In this issue of The Tablet, our new president, Ralph Lai, provides his perspective on the challenges community pharmacy faces. As I write this we have a new Minister of Health, Dr. Margaret MacDiarmid, who has faced an avalanche of issues in her first few weeks in her new position. Her many years as a working physician in both rural and urban communities give her a unique perspective on the challenges of making the health care system work. I am hopeful her hands-on experience in working with all health care practitioners will be helpful as we continue to advance the value pharmacists can bring in the delivery of primary care.
from home and needing their medications. And as we deal with the reality of another whopping cough outbreak, pharmacists will fill the gap and ensure more people get the vaccines they need close to their homes at a time that is convenient for them. I continued to be amazed that within a three-week period earlier this year some 10,000 people received their pertussis vaccine from pharmacists in the Fraser Health and Vancouver Coastal Health Authorities. And our members are getting ready to take on that challenge as well as ensuring more people than ever get the flu shot this season.
“I am heartened that the certainty of the value we provide to patients ... will ultimately come to be recognized”
But the reality is, there remains a great deal of uncertainty about what the near term holds for pharmacy. We are awaiting the government’s decisions on the regulations on pricing and incentives that may well be in place by the time you are reading this issue of The Tablet.
So, collectively pharmacy in BC appears to be in a bit of a holding pattern. We have many accomplishments in recent years that have delivered real value to patients in the province. Pharmacists’ ability to adapt and renew prescriptions is saving many trips to physicians that, in turn, allow physicians to deal with patients with complex care needs.
So, while this uncertainty creates significant challenges for pharmacy owners and managers, I am heartened that the certainty of the value we provide to patients, and the clear economic savings our members deliver through these services, will ultimately come to be recognized by our political leaders. Pharmacists have a vital role to play as a health care partner and our government’s challenge is to ensure this role is fostered and supported appropriately.
We know the medication reviews provide a real-time snapshot of the medications a patient is on that is invaluable when that patient finds themselves in emergency departments or away
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Oct/Nov 2012
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PARKASH RAGSDALE | DIRECTOR, PROFESSIONAL SERVICES
Are you ready for the flu season?
The fall marks the beginning
of the flu season, which means that influenza immunizations will be at the forefront of many pharmacists’ minds. Since last year, there has been a College of Pharmacists of BC (CPBC) policy change and provincial program changes that may affect your preparation for this year’s campaign. To standardize cold chain management across pharmacies in the province, the CPBC introduced Professional Practice Policy 68 Cold Chain Management of Biologicals (PPP-68), which became effective on July 1, 2012. All pharmacy fridges storing biologicals, including vaccines, must be able to maintain required temperature ranges of +2°C to +8°C at all times. Furthermore, under the counter size fridge/freezer combination ‘bar’ fridges are not acceptable, as they are typically not able to maintain even temperatures. The policy also requires each pharmacy to have a traceable memory refrigerator/freezer thermometer and to maintain a temperature log, at least two times daily, to ensure that the temperature inside the refrigerator is kept within the acceptable range of +2°C to +8°C at all times. More details are available on the CPBC’s website at www.bcpharmacists.org. In addition to PPP-68, cold chain must also be maintained at all times during vaccine transport. Whenever picking up or transporting vaccines, remember to bring a cooler capable of maintaining temperature ranges of +2°C to +8°C for the trip duration, and pack it appropriately with ice/gel packs and insulating material. More information is available on the BC Centre for Disease Control’s cold chain resources page at www.bccdc.ca/imm-vac/ForHealthProfessionals/coldchain/ default.htm
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There are also several changes to this year’s provincial influenza program. There will be three provincially funded influenza vaccines employed as part of the provincial program: Vaxigrip, FluAd and Agriflu. In addition, Vancouver Coastal Health Authority will be conducting a pilot with FluMist in certain public health clinics and primary care offices. Vaccine availability will vary by health authority and health unit. Eligibility for the publicly-funded influenza vaccine is expanding this year and will now also include 24 to 59 month old children and their household contacts, caregivers and day care staff. In addition, the Province is launching its Health Care Worker Influenza Control Program where staff at health authority governed facilities will be required to be immunized or wear a surgical mask for the 2012/13 flu season. While community pharmacists and their staff are not included in this policy, getting immunized against the flu is still strongly encouraged. In pharmacies offering multiple publicly-funded vaccines such as Tdap and HPV vaccines, remember that administering all vaccines for which a recipient is eligible at the time of each visit is part of the National Guidelines for Immunization Practice. Help ensure that opportunities to immunize are not missed. Last year’s flu season was an important step forward in demonstrating pharmacists’ commitment and capacity to administer a significant portion of the Province’s influenza immunizations. This year we look forward to continuing to support pharmacists as they play an even greater role in providing this valuable service to British Columbians.
CYRIL LOPEZ | CHIEF OPERATING OFFICER
Make the most of your member benefits
In my five years at the Association,
there have been times when a member has said, “This phone call and advice has paid my membership fees many years over,” or “thank you for setting up my membership and insurance coverage within the same day so I can start my new job.” However, our members can only provide such positive feedback if they experience our services and interact with our team. Many are not aware of all the benefits and services their membership offers beyond personal professional liability insurance. Affinity Rx: If you’ve thought retail discounts are not that great a saving, have a look at some of the very exclusive offers we are now bringing you under Affinity Rx. If you haven’t heard about the Telus Mobility offer, check out the last page of The Tablet to learn about this amazing deal. We also sold out all Cineplex and PNE tickets, and the worldwide hotel booking site competes strongly with Expedia’s offers. Vince Lee, our manager, is always looking for improved offers on your behalf. Job Board: We offer the best job board in pharmacy, tailored to your needs whether you are an employer looking for staff, or a staff pharmacist looking for a relief or a new job. Also, the Hire a Pharmacist section on our website has been updated. Now when General members post their resumes (for free!), new fields will help pharmacy members filter and sort through the list, including when the resume was last updated, preferred location of employment, and number of years experience.
Extended Health Insurance: For those not already part of an employer’s group plan, we offer the benefit of group rates for individual staff pharmacists. The plan is comprehensive, can be tailored to your budget, and offers some optional coverage that your employer may not. Employers should also compare the BCPhA plan cost and coverage with your existing one as you could be missing a savings opportunity. The plan is available for different groups ranging from individuals to up to 190 or more employees. Contact Johnstone Benefits (1-800-432-9707) for a quotation. Financial Affairs: As we get into the fall, it may a good time for an early review of your financial affairs. As a BCPhA member, you have two options. The first is up to two hours of complimentary consultation per year with Financial Literacy Counsel. Their team of financial counselors, accountants and legal advisors will assist you in making wiser decisions about money without the pressure of buying financial products. The other option is to consult with RBC Dominion Securities advisor and vice president, Glenn Schoenroth. Please contact me to access these advisors.
Take the time to review all the benefits available to you through the Association to ensure you are getting the most from your progroup_ad_v3.ai 13/11/2008 4:23:24 PM membership dollars.
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Subscriptions: We offer a 40 per cent discount on the Canadian Pharmacists Letter, 15 per cent on Drugstore Canada and 17.5 per cent on Lexi-comp database subscriptions.
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Oct/Nov 2012
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MOVEMBER
A phar-MO-cist gives back
One in seven men will be
seeking out sponsorship for their efforts. The funds raised go to programs run directly by Movember and Prostate Cancer Canada.
diagnosed with prostate cancer in their lifetime, and an estimated 25,500 men will be diagnosed with prostate cancer in Canada this year alone.
The Movember movement began in Melbourne, Australia, in 2003 and grew from an original 30 participants to more than 854,000 men and women raising $125.7 million in 2011.
That’s why Satnam Lalli, pharmacist and owner of the Pharmasave Broadmead in Victoria, graciously donated his upper lip to “Movember,” the month in which men commit to growing moustaches and raising awareness for prostate cancer research.
Based on the success of the campaign so far, Lalli knew his “mo” would spark conversations – and no doubt generate some laughs – all in the name of raising vital awareness and funds for prostate cancer. “Our patients were very supportive and very encouraging,” Lalli said of his experience last year. “Many of our patients disclosed information about close friends and relatives who have been affected by prostate cancer.” In 2011, he raised more than $5,000 through his own “mo,” with Pharmasave Broadmead matching these donations to bring Lalli’s total up to $10,384. “As a pharmacist, I see the impact of prostate cancer on our patients and their families, and as a result I wanted to do something to minimize the impact,” said Lalli.
Pharmacist Satnam Lalli shows off last year’s mo
On November 1st, men register with a clean-shaven face, and for the rest of the month, grow their way into a fine sporting moustache, while tracking their progress and
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This year he will be away travelling for most of November, but says his staff at Pharmasave will carry on with fundraising. As well, they’ll continue to play an important role with patients with prostate cancer. “Community pharmacists have the tools
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to recommend appropriate drug therapy and to help patients with symptom management, whether through prescription or non-prescription medications,” said Lalli. “We can also help them optimize their medication therapy by making them aware of drug interactions and provide appropriate counseling whether it is drugbased or holistic. And, we can refer them
Risk factors for prostate cancer There is no single cause of prostate cancer. However, there are some factors that make developing prostate cancer more likely. • Age: The chance of getting prostate cancer rises quickly after a man reaches age 50, and almost two out of three prostate cancers are found in men over 65. Age is the most important risk factor for prostate cancer. • Race: It is not known why, but prostate cancer is more common in men of African or Caribbean descent and less common in men of Asian descent. • Family history: Your risk of prostate cancer is increased if close family members have had the disease. • Diet: Men who eat a low-fibre, high fat diet have a higher rate of prostate cancer. Research suggests that saturated fat increases the production of the hormone testosterone, which may help prostate cancer cells grow.
to other resources including websites and support groups.”
Men treated for prostate cancer could benefit from aspirin
He notes that community pharmacists are ideally situated to increase awareness of prostate cancer. “As the most accessible health care professionals in the community, and with our knowledge and training, we’re in a perfect position to raise the profile of the disease.”
A new study published in The Journal of Clinical Oncology (Choe K, et al. August 2012) found that men who had been treated for prostate cancer were less likely to die of their cancer if they took aspirin regularly.
This is critical, as getting screened regularly can lead to early detection and treatment, and greatly increased chances of survival. Prostate cancer can be slow-growing and some men who develop prostate cancer live many years without ever having the cancer detected. However, a significant proportion of prostate cancers, if untreated, may have serious consequences. Typically, the first symptoms of prostate cancer are difficulty urinating, frequent urination, and blood in the urine.
The study involved nearly 6,000 men from the database of Cancer of the Prostate Strategic Urologic Research Endeavo, all of whom had localized adenocarcinoma of the prostate and had already undergone treatment with either surgery or radiotherapy. Slightly more than one-third of the men (2,175) were receiving anticoagulants including warfarin, clopidogrel, enoxaparin and/or aspirin. Researchers compared the 10-year mortality rates between those taking anticoagulants and those who were not, and found a significantly lower risk of dying from prostate cancer among those who took anticoagulants (three per cent death rate versus eight per cent).
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The effect was greatest for those men with high risk disease (four per cent versus 19 per cent, respectively). Results also suggested that those taking anticoagulants were less likely to see a recurrence of the cancer or bone metastasis. Further analysis suggested that those who were taking aspirin specifically saw the greatest benefit, as opposed to the other types of anticoagulants. While anticoagulants, including aspirin, are associated with an increased risk of gastrointestinal bleeding or hemorrhagic stroke, the researchers concluded that for patients with prostate cancer, the benefits far outweighed any potential harms.
Oct/Nov 2012
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BREAST CANCER AWARENESS
A pharmacy dressed in pink Summer in Kelowna is
and patient and, because I knew more about what was happening in their lives, I could help them with issues surrounding their treatment.”
usually a time of hot, sunny weather, afternoons by the lake, and an influx of tourists to the beautiful Okanagan. For the staff of Dyck’s Pharmacists, it’s also time to start decorating their stores in pink and fundraising for the next Run for the Cure. The Canadian Breast Cancer Foundation’s CIBC Run for the Cure is Canada’s largest single day, volunteer-led fundraising event dedicated to raising funds for breast cancer research, education and awareness programs. Last year, Canadians raised more than $30 million in the Run, with more than 170,000 annual participants. This year’s run took place on September 30th. Dyck’s Drug Runners is a team from the four Dyck’s Pharmacists locations in Kelowna including pharmacists, pharmacy technicians, nurses, and delivery drivers. Pharmacist and BCPhA General member Keya Morasse has been on the team for three years and got involved for a multitude of reasons. “On a personal level, I’ve lost two grandparents to cancer,” said Morasse, explaining her motivation for running with the team. “We also do hospice work at our pharmacy, so I see firsthand how it affects families.”
Cancer is often a very personal struggle, she added, so patients usually aren’t very open about it. Because patients generally undergo treatment at the cancer centre, they’re sometimes surprised to learn a community pharmacist can help them. “Once they find out that we can help, they come to us a lot more often, especially since we’re so easily accessible.”
She’s been participating in the Run for the Cure since she started working at the pharmacy almost 18 years ago. “We usually start decorating the pharmacy in mid-July,” Kothlow said. “We set up donations boxes, decorate everything in pink, sell tickets for a gift basket draw, even do a bottle drive. All the money raised is donated to the cause.” This year, they held their first dinner fundraiser at a local restaurant, with $12 from each ticket sold going towards their cause. In addition to participating as a corporate team
Community pharmacists often support cancer patients with symptom management, such as counseling on chemotherapy side effects or treating a patient with radiation burns in their mouth with lidocaine oral.
01 S helley Kothlow, LPN and home healthcare manager, and husband Al Kothlow hold down the Dyck’s Pharmacists tent at the Kelowna Run for the Cure.
Another reason behind Morasse’s participation was what she called the “contagious enthusiasm” of Shelley Kothlow, home healthcare manager at the downtown location and Dyck’s Drug Runners’ team captain.
02 Dyck’s Pharmacists also held a gift basket draw to raise money for the cause. 03 Dyck’s Drug Runners team, including Shelley Kothlow [middle row, left] and BCPhA General member Keya Morasse [middle row, second from left].
As one of the LPNs in the pharmacy, Kothlow sees breast cancer patients on a weekly basis when they come in for fittings for lymphedema garments or arm sleeves.
After working in community pharmacy for 10 years, she’s had quite a few patients that have had breast cancer, but notes you often wouldn’t know it to look at them. “When I first did the Run for the Cure a few years ago, I saw patients participating that I hadn’t even know were dealing with breast cancer,” Morasse said. “They were always so cheerful and happy in the pharmacy and never exhibited any stereotypical signs. After running with them, it really strengthened the bond between pharmacist
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Did you know? October is Breast Cancer Awareness Month Breast cancer is the most frequently diagnosed cancer in Canadian women. An estimated 22,700 women in Canada will be diagnosed with breast cancer and 5,100 women will die from the disease in 2012 alone. 03
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for the past few years, Dyck’s Pharmacists is also a sponsor of the run. In 2010, when Barb Hoy retired from Dyck’s Pharmacists after 30 years as a community pharmacist, she volunteered to serve as the Run Director for the Kelowna event. “When Barb was retiring, she researched different charities, and decided this was the one she wanted to dedicate her time to,” said Morasse. “When someone you respect is putting everything into that one charity, it’s really inspiring.” It seems all the staff at Dyck’s Pharmacists have been inspired, with thousands of dollars raised each year for the cause. Morasse noted that those who donate their time often reap the rewards themselves as well. “If you’re feeling stressed or down, as soon as you can make somebody else’s life a little easier, you really feel better,” she said. “As pharmacists, we see patients daily with new diagnoses and health problems, and it’s so rewarding to know you can do seemingly simple things to make their lives a little better. You don’t have to spend a ton of time fundraising, but getting involved can be enough to make a difference.”
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JASON MIN AND LARRY LEUNG | CLINICARE PHARMACISTS
Complex Regional Pain Syndrome While providing services for enhanced
clinical patient care in community settings, we have been fortunate to come across many interesting cases that leave us scratching our heads. This new column aims to present some of those complex cases, which we hope will stimulate discussion and thought. Recently, a patient was referred to us that had been diagnosed with Complex Regional Pain Syndrome (CRPS): • 34-year old female with sensitivity, edema, severe pain in her right arm. • Injury from a seemingly benign fall off bike and laceration of right forearm on glass. • Symptoms of disproportionate pain did not present until three months after injury. • Experiencing allodynia and hyperalgesia resulting in unbearable pain even from gentle touch of a cotton ball. The patient was taking pregabalin 75mg twice daily and nortriptyline 50mg at bedtime, and had received several lidocaine nerve blocks. Her previous therapy included ketamine and opioids. The current medication regimen was not effective for controlling pain and attempts to increase doses had not been tolerated. The patient’s physician referred her to us for medication management and inquired about therapy options beyond opioids, antiepileptics or antidepressants. CRPS is a chronic, progressive condition characterized by severe pain that can affect any area of the body, but often affects an arm or leg. Symptoms include burning pain, hyperalgesia, allodynia, sweating, and skin and temperature changes in the affected area. There are many theories for the potential cause of CRPS including dysregulation of the autonomic nervous system and nerve damage. Treatment often requires a multidisciplinary approach, combining medications with physical therapy and nonpharmacological measures.
Questions that came to our mind when deciding with the patient on the best therapy included: - Has she tried optimized doses of any other medications, including any acetaminophen or NSAIDs? - What other therapies are available and what evidence is there to support it? - Does the patient have any preferences for her therapy? Since the patient had already been given adequate trials of her existing medications and was not able to increase doses due to tolerability, we needed to find alternatives. Our literature search revealed a particularly helpful review article exploring the evidence behind the use of calcitonin, bisphosphonates, steroids, and dimethyl sulfoxide (DMSO). In the review, bisphosphonates were deemed the best alternative, as calcitonin did not reliably reduce pain, steroids had limited benefits in short courses only, and DMSO was only mildly helpful. Patients on alendronate displayed better pain control and range of motion compared with placebo at weeks four, eight and twelve. Edema, a symptom experienced by our patient, also improved with alendronate at four and eight weeks. Among other things, we recommended a trial of alendronate 40mg once daily, which was the studied dose. After four weeks our patient reported some pain relief, a reduction in swelling, and some improvements in range of motion. The plan was to continue therapy and follow-up in four weeks for reassessment. We understand that there were many potential alternatives what would you recommend? Visit us on Facebook at Clinicare Pharmacists to join the discussion. Larry Leung and Jason Min are directors of Clinicare Pharmacists Inc. and lecturers at UBC. They have a passion for interdisciplinary care and the development and implementation of innovative clinical pharmacy services in the community.
References 1. Tran D, Duong S, Bertini P, Finlayson RJ. Treatment of complex regional pain syndrome: a review of the evidence. Can J Anesth/J Can Anesth (2010) 57:149–166.
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FLU UPDATE
NEW MEMBERS
Flu season promotional materials on their way This flu season, BCPhA members
will receive a number of promotional materials encouraging patients to “Ask your pharmacist about your flu shot.” Developed by Immunize BC, these shelf talkers, bag stuffers and flu clinic (date and time) posters will increase awareness among the public that their community pharmacy can offer a quick and convenient option for this year’s flu shot. Start the conversation now – more than 100,000 publicly-funded vaccines were administered by pharmacists in the 2011/12 flu season, with an even greater number expected this year. There are now more than 1,900 community pharmacists authorized to inject in BC. We hope you enjoy and use these promotional materials. If you’re doing a great job in your pharmacy promoting and offering flu shots, make sure to contact Elise.Riedlinger@bcpharmacy.ca so we can share your story!
Welcome to BCPhA! We are pleased to welcome the newest members of the Association and look forward to representing your interests as pharmacists and advancing your role as primary health care providers.
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General Maria Acierto, Mary Azzer, Jagjit Bangar, Firoj Banglawala, Crystal Borody, Farah Caflisch, Priscillia Cavanagh, Johanne Chaine, Lucy Chu, Jason Cridge, Charetie Dolor, Robby Dosange, Nermin El Shamy, Heidi Fritsche, Karim Gabra, Lisa Green, Teresa Hui, Linda Jiao, Margrat Jim, Dragana Kosoric, Della Kwan, David Lee, Mark Leong, Laura Lewis, Shih-Han Hans Lin, Robson Liu, Thi Nguyen, Eunice Park, Cindy Preston, Khushminder Rai, Rhys Rossiter, Rebecca San, Reginald Smith, Salwa Sokar, Shabuddin Syed, Andrew Tam, Hyesung Yoon, David Yorgason, Lina Youssef, Su Yue
TO YOU
For more infor mation abou t the Influenza vacc ine call Hea lthLinkBC at 8-1-1 or visit our web site.
immun
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LOCA TION
DATE
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01 Pharmacy bag stuffer 02 Flu clinic date and time poster
e Mak tion n e ! v e Pr ous tagi T Con ARMACIS
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03 Immunize BC shelf talker 03
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ON THE COVER | UBC UPDATE
Welcome to the new Pharmaceutical Sciences building at UBC On September 17, 2012, the University of British Columbia officially opened the new Faculty of Pharmaceutical Sciences building, a stateof-the-art learning and research facility that will enable UBC to graduate 224 new pharmacists per year by 2015 and more than double the research space for drug discovery and health care innovation. The $133 million, 246,000-square-foot building also supports the expansion of Masters, Doctoral, and Doctor of Pharmacy programs, and offers a new home to several other research organizations, including the Centre for Drug Research and Development. “Our Faculty is committed to innovation in learning, research and practice to inspire wellness and health outcomes,” said Dean Robert Sindelar. “Our new building’s collaborative learning and
research infrastructure will greatly increase our capacity to lead the world in pharmaceutical sciences and create an environment that challenges our students to address real world health issues.” The new building also includes the Story of Medicines, an interactive exhibit that tells the story of pharmacy through hands-on touch screen technology, games, and historical pharmacy artifacts to help students and visitors better understand the pharmacy profession, the development of drugs and how they interact with the body. In addition, a proposed pharmacy clinic will enable students and practitioners around the province to gain valuable experience working with patients. Supervised by licensed pharmacists, students will provide medication counseling to members of the public.
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01 M elissa Patton, BCPhA Student Ambassador [far right], enjoys the study space outside the new BCPhA Student Commons with fellow pharmacy students. (Credit: Vince Lee, BCPhA) 02 The entrance to the new Pharmaceutical Sciences building at UBC. (Credit: Vince Lee, BCPhA) 03 Honourable Ralph Sultan, Minister of State for Seniors [r], interacting with the Story of Medicines at the new UBC Pharmaceutical Sciences building with Dean Robert Sindelar. (Credit: Martin Dee, UBC) 04 The new building was designed by Saucier + Perrotte Architectes of Montreal and Hughes Condon Marler Architects of Vancouver. (Credit: Vince Lee, BCPhA)
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05 The proposed pharmacy clinic will enable students to provide medication counseling to the public, while supervised by licensed pharmacists. (Credit: Vince Lee, BCPhA) 06 The new BCPhA Student Commons offers a space for student learning and engagement, as well as club and social activities. (Credit: Vince Lee, BCPhA)
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UBC UPDATE
White Coat Ceremony An annual tradition
By choosing to study “pharmaceutical sciences, you
at UBC’s Faculty of Pharmaceutical Sciences is the White Coat Ceremony that officially inducts first-year undergraduate, Pharm. D., and graduate students into the program.
have also made the decision to become a medication expert … You are preparing yourself to be the ‘go-to’ person on medication usage as part of a team of professionals whose purpose is to improve the health and well-being of the people who live and work around you.
In recognition of the Association’s gift to the new Pharmaceutical Sciences building, BCPhA was the co-presenter of this year’s ceremony, and will continue to hold this prestigious role for future ceremonies. BCPhA president Ralph Lai welcomed students to the profession and participated in cloaking students with their first white coat, along with CEO Geraldine Vance, past president Greg Shepherd, and Board members Shakeel
– Mark Dickson 02
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Bhatti, Allison Nourse, and Nadeem Zia. (A number of the other White Coat Presenters were BCPhA members, selected by UBC based on their corporate and other affiliations.)
01 From left to right: Allison Nourse, uniPHARM Wholesale Drugs, BCPhA Board member; Paul Buxton, Apotex; Ralph Lai, Overwaitea Food Group, BCPhA Board president; Geraldine Vance, BCPhA CEO; and Nadeem Zia, Fraser Health Authority, BCPhA Board member. (Credit: Jimi Galvão, UBC)
This year’s keynote address was given by Mark Dickson, national director of pharmacy for Pharmasave Drugs and pastchair of the Canadian Association of Chain Drug Stores. (We have shared excerpts from Dickson’s address on these pages.) Witnessed by family, faculty members and numerous pharmacy education stakeholders, the ceremony also highlighted the students’ Pledge of Professionalism.
02 Keynote speaker, Mark Dickson, national director of pharmacy for Pharmasave Drugs and past-chair of the Canadian Association of Chain Drug Stores. (Credit: Jimi Galvão, UBC)
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03 First year pharmacy students receive their white coats and are officially welcomed as future professionals. (Credit: Jimi Galvão, UBC)
“Advancing technology extends
both the realm of what is possible and what is expected from a care perspective. We are seeing these advances change the landscape by making health care delivery closer to home a reality. You will be part of this change and you will make a difference. – Mark Dickson
04 The Association’s gift to the new Pharmaceutical Sciences building will continue to be recognized through BCPhA being the co-presenter in perpetuity of the annual White Coat Ceremony. (Credit: Jimi Galvão, UBC) 05 First year pharmacy students recite the Pledge of Professionalism. (Credit: Jimi Galvão, UBC)
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MARK HO | STUDENT NEWS
A new year and a new home This past summer
was a wonderful time for students to catch up on lost sleep and just refuel after a grueling year at school. However, that doesn’t mean the time was unproductive. For second and third years, they did their onemonth rotations at community pharmacies, where the staff and pharmacists mentored them. A huge thank you to all the staff and pharmacists that supported us! For myself, I went to Kamloops for my rotation, and it was my first time out of the Lower Mainland. It was definitely a different, yet pleasant experience. The city was much less congested and the people were much friendlier than those in bigger cities. When I was interacting with patients at the pharmacy, they actually wanted to talk! I was surprised at how open and educated patients were about their medical conditions, and the trust they placed in pharmacists. They didn’t have the hustle and bustle attitude of those in the Lower Mainland, which made my time as a student much easier. Let’s just say I have now expanded my horizons on where I may want to practice after graduation. September was an interesting time as everyone got settled in. There were a lot of events to celebrate our new pharmacy building, including a Family Toast with the Dean, the Official Opening Ceremony and the Alumni Open House events. However, the most celebrated event must have been the “Lip Dub” organized by the undergraduates – make sure to check out this lip-synching video involving the pharmacy students on YouTube. School is now back in full swing and students are certainly enjoying taking classes in the new location (with the exception of those in fourth year away on rotations). Most classes take place in the new London Drugs Lecture Theatre, equipped with microphones and electrical outlets at every seat. Also, there is a larger practice lab, larger classrooms, and plenty of study space. Of course, students
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can look forward to relaxing at the BCPhA Student Commons and grabbing a quick bite at the food outlet in the atrium. And let’s not forget the Story of Medicines, where everyone can interact with floor-to-ceiling touch screen computers. We are so lucky to be a part of this new milestone for our program, and we are all looking forward to an exciting year in our new home!
ark Ho, president of the Pharmacy Undergraduate Society, M welcomes the incoming class of 2012 at the White Coat Ceremony. (Credit: Jimi Galvão, UBC)
SASKATCHEWAN COMPARISON
Treating minor ailments in Saskatchewan It happens every day
in pharmacies across Canada. Someone comes to the counter with a question about a rash or an insect bite and wants advice on how to treat it. For most community pharmacists, the options are an over-the-counter medication or to suggest the patient see a doctor – and the time spent consulting is written off as the cost of doing business. However, in Saskatchewan, community pharmacists now have the authority to prescribe specific “Schedule 1” drugs for the treatment of seven minor ailments, including rashes, cold sores, hay fever, allergic rhinitis, diaper dermatitis, oral aphthous ulcers and oral thrush. The process that brought Saskatchewan pharmacists to this point began in March 2010 with the Saskatchewan Minister of Health announcing his intention to approve regulations and bylaws expanding pharmacists’ authority to prescribe drugs, which at the time was limited to emergency contraceptions. An interdisciplinary Advisory Working Group, including physicians, pharmacists, nurses and dentists, developed the policies that were then approved by the Saskatchewan College of Pharmacists Council. “The scope of practice change was really driven by the provincial government and
the College,” said Dawn Martin, executive director of the Pharmacists’ Association of Saskatchewan (PAS). “They deserve the credit for Saskatchewan being the first government in Canada to fund the service.” Fourteen conditions were initially approved by the Saskatchewan College of Pharmacists Council for minor ailment services. Three were approved for pharmacists to assess and prescribe as of February 1, 2012 – acne, cold sores and insect bites – with an additional four approved on May 24 of this year.
The challenge, according to Martin, is that the assessment fee only applies when the pharmacist writes a prescription. Dawn Martin, executive director of the Pharmacists’ Association of Saskatchewan (PAS).
Under the minor ailment program, the patient consults with a pharmacist for advice about treatment of a minor ailment or condition. If the condition meets a specific set of criteria, and the pharmacist determines the best treatment option is a Schedule 1 drug, the pharmacist can initiate a prescription. The criteria are that the ailment can be reliably self-diagnosed by the patient and is a self-limiting condition; lab tests are not required for diagnosis; treatment will not mask underlying conditions; medical and medication histories can reliably differentiate more serious conditions; and only minimal or short-term follow-up is required.
“If the pharmacist determines that an over-the-counter medication will suffice, or the patient’s symptoms are severe and warrant a referral to a physician, the assessment fee does not apply,” explained Martin. “We’re still doing the assessment and the consultation, but we’re not being reimbursed. We see it as a perverse continued on page 23
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CROHN’S AND COLITIS
Get gutsy: November is Crohn’s and Colitis Awareness Month More than 200,000
Canadians – an estimated one in 160 – live with Irritable Bowel Disease (IBD), experiencing agonizing and debilitating pain that can last for months or even a full year without diagnosis. Canada has among the highest rates of IBD in the world and to date there is no cure or known cause. IBD is comprised of Crohn’s disease and ulcerative colitis: two similar, yet distinct conditions that cause intestinal tissue to become inflamed, form sores and bleed easily. While Crohn’s can affect any part of the gastrointestinal tract, colitis affects only the inner layer of the colon and always starts in the rectum, causing continuous inflammation that may spread into the rest of the colon. Most people are diagnosed by the age of 30, and many will experience periods of both remission and flare-ups, often requiring long-term medication, hospitalization or surgery. During a flare-up, patients suffer from symptoms including abdominal pain, cramping, fatigue, urgent diarrhea and bloody stools. Additional symptoms include nausea, bloating, anaemia, joint pain, canker sores, skin and eye irritations and weight loss. IBD cannot be cured by drugs or surgery, although both are proving to be helpful in relieving symptoms. Julie Foreman is the pharmacy manager at Forbes Pharmacy in Victoria, which offers an infliximab (Remicade) infusion clinic for patients with inflammatory
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conditions such as Crohn’s and colitis. She’s worked with a large number of patients with bowel disease and says they often express frustration over the difficulties in treating their condition, as well as the huge impact it has on their lives. “Patients are looking for someone who has the time to listen to their concerns, whether they’re about drug therapy, lifestyle management or psychological effects such as anxiety or depression from dealing with a significant inflammatory condition,” said Foreman. “They often come to pharmacists seeking information and clarification about prescription therapy, as well as supplements and dietary measures.” At her previous pharmacy, Foreman began doing one-on-one consults with patients after finding there was a need to get more background information on their condition. Now that medication reviews are a funded service, she says she’s able to reach even more patients. “As pharmacists, we can help patients devise a treatment plan that fits their individual needs, as well as provide accurate information, reassurance and compassion when they’re feeling overwhelmed,” she said. “Their conditions often do not have any easy ‘fix it’ type therapy. There are recurrences of symptoms and an impact on daily activities.”
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While there are many approaches to treating IBD with over-the-counter therapies, Foreman emphasizes that these should complement but never replace prescription medications. “If significant inflammation is present, I recommend L-glutamine 500mg (an amino acid specific to healing intestinal cells) three times daily for 30 days to repair intestinal walls,” she said. “As well, VSL #3 probiotic daily for 30 days or alternatively, the most broad spectrum probiotic with 10 billion cells/day or more, such as Bio K.” She also encourages patients to take fibre, omega-3s, vitamin and mineral supplements, and focus on stress management and dietary considerations to avoid triggers or irritants. “Often people seek relief from diarrhea by using OTC products like Immodium (loperamide). This can be an effective treatment for certain patients but there are concerns in severe bowel disease with risk of toxic mega colon.” Foreman recommends working with the physician if a patient is self-treating with loperamide, and in general advocates sharing and seeking information from other health care practitioners. “Treating IBD is a multi-faceted approach and there is a lot to learn from gastroenterologists, naturopaths, dietitians and others.” In terms of prescriptions, she finds the most common include oral medications
such as prednisone, 5-ASA, azathioprine, or methotrexate, as well as infusions such as infliximab and rectal steroid or 5-ASA foams, ointments and suppositories. Foreman says the best advice she can give to other pharmacists with IBD patients is to listen and try to assist them with an individualized approach to managing their condition. “Most times there will be significant stress occurring because of their flare symptoms,” said Foreman. “Having a callback service or keeping notes to remind you to check in with these patients when they come in for refills helps to tailor the management and prevention of flares. “My hope is that I’ve been able to help my patients become better educated about managing their IBD management and as flarefree as possible.” For more information on Crohn’s and Colitis Awareness month, please visit www.getgutsymonth.com.
Julie Foreman, pharmacy manager at Forbes Pharmacy in Victoria
Treating minor ailments in Saskatchewan continued from page 21
incentive, and it’s one of the issues we’re still working out with government.” Before being able to prescribe, community pharmacists must first complete Level 1 training, a one-day course offered by Continuing Professional Development out of the University of Saskatchewan, with oversight from the College. To date, 900 of Saskatchewan’s 1,300 community pharmacists have completed mandatory training for assessment of minor ailments. “We also recognize that pharmacists should be reimbursed for training,” said Martin. “So we are providing grants to those pharmacies with at least one pharmacist who has completed the minor ailment training. To date, we have provided $1,500 grants to 290 of our 350 pharmacy members, with that funding coming from the $1 million Alternative Reimbursement fund, established in the 1990s from voluntary contributions from prescription billings.” The next step is a public awareness campaign being launched this fall, using shelf talkers, cards describing what pharmacists can now do, advertisements in rural newspapers, radio talk shows and social media. “We’re working on a limited budget,” said Martin, “but we’re confident that we can get the word out about the role pharmacists can play across the province to help people manage many minor ailments. “Our slogan is Pharmacists: Providing more options to improve your health.” Martin also pointed out that between February 1 and June 30 of this year, 591 assessments have been completed representing fees of about $10,500. “That is a significant achievement in terms of patient access to a health care professional, particularly when you consider that it’s still early days. It will take a bit of work to get things rolling, but Saskatchewan pharmacists are ready and eager to provide their services.” Here in British Columbia, the current clinical pharmacy services are adaptations, injections and medication review services. The Saskatchewan experience represents an opportunity to bring best practices from our neighbouring provinces to benefit British Columbians’ access and choice in treating minor ailments.
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DPIC
Raymond Li, B.Sc. Pharm., M.Sc.
A focus on osteoporosis Talk about osteoporosis risk in your male patients. Safety concerns with treatments are still being evaluated, but in most cases benefits outweigh the risk of adverse effects. Calcium is still required for healthy bones, but intake should be through diet rather than supplements, and more is not better. All adults should take a vitamin D supplement. Smoking cessation and avoiding excessive alcohol intake can reduce the risks of both osteoporosis as well as adverse effects of treatment.
There are a number of important
awareness campaigns this fall, including Osteoporosis Awareness Month in November. This column highlights a few emerging issues.
Osteoporosis in men Although osteoporosis is more common and occurs earlier in women, men account for 20 per cent of patients with osteoporosis and a disproportionate number of osteoporosis-related fractures. Mortality following fractures of the hip is also two to three times higher compared to women. There is a need for increased awareness of the problem, and clinical practice guidelines for assessing and treating osteoporosis in men have recently been published.
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Treatment options have not been as thoroughly studied in men as in women, and outcomes have focused mainly on bone mineral density (BMD) rather than fractures. However, many of the same therapies are recommended. Antiresorptive agents like alendronate, zoledronic acid, and risedronate, and anabolic agents such as teriparatide have indications for treating osteoporosis in men. Hormone therapy in men is not a first-line therapy for osteoporosis alone but testosterone may be considered as an initial treatment for men with osteoporosis who also have symptomatic hypogonadism. Testosterone has been shown to maintain BMD but it has not been shown to reduce fracture rates, so if there is no relief of hypogonadal symptoms after three to six months, discontinue testosterone and use another approved bone therapy.
Treatment related safety issues Calcium and myocardial infarction (MI) Many patients do not get enough calcium from their diet and require a supplement to reach the goal of 1000-1200 mg calcium intake. However, recent studies have shown an association between calcium supplement use and increased risk of MI (20-86 per cent increase) and stroke (20 per cent increase). Dietary calcium was not associated with an increased risk. It has been hypothesized that unlike dietary calcium, supplements produce high peak serum calcium levels that may promote atherogenesis. The findings have elicited much debate, and some feel that cardiovascular concerns are premature. However, patients should try to obtain their calcium requirements through diet, and not exceed 1200 mg/d. If supplements are needed, patients should not take more than 500-600 mg elemental calcium at a time; smaller doses taken more frequently are preferred. Cancer Following a warning from the European Medicines Agency, Health Canada is assessing cancer risks with calcitonin. Calcitonin is not recommended as a first-line treatment.
reason for considering a drug holiday, but whether or not interrupting therapy reduces treatment-related harms has not been studied. Based on available evidence, drug holidays may be considered for women who have been compliant with at least three years therapy with zoledronic acid or five years therapy with alendronate and are not at higher risk for fracture (femoral neck T score <-2.5, or history of vertebral fracture and T-score <-2.0). In addition, the following have been suggested for patients with concerns about treatment side effects: • Intermediate fracture risk*: discontinue bisphosphonates after five years, monitor BMD every two years and bone turnover markers (BTM) yearly; resume therapy if significant declines in BMD or significant increases in BTM or new fractures • High fracture risk*: continue bisphosphonates for at least 10 years, monitoring oral health and thigh pain. Then consider teriparatide for two years as a holiday from bisphosphonates. If teriparatide is not an option, stop bisphosphonates but monitor BMD and BTM as above, and resume therapy if significant declines in BMD or >40 per cent increase in BTM.
There may also be a connection between oral bisphosphonate use and esophageal cancer, but so far the absolute risk is likely to be small – it has been estimated from one study that there would be one additional cancer case per 1000 patients treated for five years.
*based on the WHO fracture risk assessment tool (FRAX) and clinical assessment (e.g. frailty, fall risk)
Atypical femoral fractures, osteonecrosis of the jaw
A recent meta-analysis found that supplementation with at least 800 units/day in patients 65 years and older was associated with a 30 per cent reduction in hip fracture and 14 per cent reduction in any non-vertebral fracture. Lower vitamin D does not have any protective effect.
Bisphosphonates suppress bone remodelling that leads to bone loss, but this can also suppress bone repair and lead to increased brittleness. Studies have found an increased risk for atypical femoral fractures associated with use of bisphosphonates for at least several years. However, the risk appears to be low – about one per 1000 users per year. Thigh, hip, or groin pain may precede these fractures. Bisphosphonates have been associated with osteonecrosis of the jaw (ONJ). The risk is greatest with high doses used in cancer patients. While the exact occurrence is not known, it appears to be is much lower with oral agents used in osteoporosis (less than one per 1000 patients). Prevention is key: counsel patients about maintaining good oral hygiene, smoking cessation, and ask about gum problems, pain or swelling.
Elective drug holidays Continuous treatment seems to provide the most benefits, but there is evidence (at least in women) that some BMD and fracture-preventing benefits persist for several years after stopping alendronate and zoledronic acid, raising the possibility of drug holidays. At present, no definite recommendations can be made. Some experts recommend that most patients on long-term bisphosphonate treatment be offered a drug holiday, while others recommend that treatment be continued. Concern over the long-term safety of bisphosphonates is probably the strongest
Vitamin D for everyone
Most Canadians are at risk for low vitamin D levels from autumn to spring and it is difficult for adults to obtain sufficient vitamin D from diet alone. Health Canada recommends that all adults over the age of 50 years supplement daily with 400 units of vitamin D, but Osteoporosis Canada recommends higher doses: 400-1000 units for most adults 19 to 50 years, and 800-2000 units/d for older adults and those with osteoporosis, fractures, or malabsorption. Weekly or monthly dosing may be a more convenient option for some patients.
Resources: Osteoporosis Canada has more information as well as tools for patients to help assess their risk and calculate their calcium intake and need for supplements. Visit their website at www.osteoporosis.ca. References available upon request; contact the BCPhA communications team. Raymond Li is a pharmacist with the BC Drug and Poison Information Centre (DPIC). DPIC answers a wide variety of drug information questions from pharmacists and other health professionals throughout BC.
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SKIN CARE PHARMACY
Elham Rahmani Neishaboor, Pharm. D., Ph.D.
Synthetic skin substitutes for tissue regeneration Loss of large portions of skin integrity from
burns, wounds or diseases may result in significant disability or even death. However, skin replacement has been a challenging task for surgeons because of transplant limitations. Tissue engineering has emerged as an alternative treatment to traditional autografts and allografts for excessive skin loss. Such an approach involves polymeric scaffolds, cells and biological factors alone or in combination.1-3
Although various forms of tissue-engineered skin exist, such as Dermagraft™, Apligraft™, Biobrane™ and Integra™, all of them focus on promoting early stages of healing and tend to form hypertrophic scarring (HSc).1, 2 HSc represents an undesirable endpoint of wound healing, where excessive extracellular matrix (ECM) accumulation results in bulky and inelastic scars that pose serious psychological and functional problems for burn patients, particularly children.4, 5
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Synthetic skin substitutes Synthetic skin substitutes are acellular products engineered without allogenic cells. They function as dermal templates or matrices that promote tissue repair or create a neodermis. They might contain a removable silicone epidermal layer to help protect the wound from moisture loss and contamination. Biobrane™ (UDL Laboratories, Inc, Rockford, IL) is a biosynthetic skin substitute consisting of a bilaminate membrane of nylon mesh bonded to a thin layer of silicone. The mesh is coated with porcine type I collagen-derived peptides (dermal analogue). The silicone layer then functions as epidermis. Small pores are present to make Biobrane™ semi-permeable to allow exudates to escape. The wound heals as host fibroblasts and capillaries occupy the wound and repair the dermal defect. As skin regeneration takes place, Biobrane™ separates from the wound, allowing easy removal. Biobrane™ is indicated for clean, superficial partial-thickness burns not involving chemicals or
petroleum-based products and for temporary coverage of freshly excised deep partial or full-thickness wounds.6 It may also be used for coverage of skin graft donor sites.
and development, will differ from the existing ones by ultimately providing two combined features: provision of an optimal healing environment and prevention of hypertrophic scarring.
Integra™ (Integra Life Sciences Corp, Plainsboro, NJ) is a synthetic bilayer acellular skin substitute composed of an outer silicon sheet (epidermal analogue) with a matrix composed of bovine collagen and glycosaminoglycan (dermal analogue). Integra provides a matrix for regeneration of the dermal structure. The wound gradually remodels or resorbs the matrix to create a neodermis as it is incorporated into host tissue over a three to six week period.7 After adequate vascularization of the matrix has occurred and the neodermis has formed, the silicon sheet may be removed and skin grafting performed. This is usually accomplished 21 to 28 days after placement. Alternatively, many smaller wounds may re-epithelialize without the need for grafting. Integra™ was first approved by the US FDA for wound coverage after excision of life-threatening deep partial or full-thickness burns when sufficient autograft was not available for wound coverage or when autograft is not desirable because of other circumstances, as well as reconstruction after excision of postburn scar contractures.8 Integra™ has other indications including pressure ulcers, venous ulcers, diabetic ulcers, surgical wounds (e.g. donor sites/grafts and post-laser surgery) and traumatic wounds.
Conclusions
Nanofiber skin substitutes: new generation of skin substitutes
2. N orton JA, Barie, P.S., Bollinger, R.R., Chang, A.E., Lowry, S., Mulvihill S.J., Pass, H.I., Thompson, R.W., Shirazi, M.K. . Surgery: Basic Science and Clinical Evidence. 2nd ed; 2008.
At the present time, there are no models of tissue-engineered skin that completely replicate the anatomy, physiology and aesthetic nature of uninjured skin.6 Nanofiber matrices with morphological similarities to the natural extracellular matrix, characterized by ultrafine continuous fibers tend to be the most appropriate structure for fabrication of soft tissue engineering scaffolds.6, 7 Electrospinning has emerged to be a simple, elegant and scalable technique to fabricate nanofiber scaffolds.8 Using electrospun nanofibers to produce a skin scaffold will allow scientists to precisely design the scaffold architecture at a feasible cost.
3. M acNeil S. Progress and opportunities for tissue-engineered skin. Nature. 2007; 445(7130): 874-80.
Recently, ELMARCO and HemCon Medical Technologies Inc. announced their agreement to develop and commercialize products using the ELMARCO NanospiderTM platform for the wound care market, valued at an estimated $5.5 billion. Nanofiber scaffolds can also be functionalized with several bioactive molecules to provide cells with the necessary signals and a more in vivo-like environment.8, 9
Drug-eluted nanofiber skin substitutes Drug-eluted skin scaffolds functionalized with anti-fibrogenic factors will not only promote healing but also mitigate the propensity of hypertrophic scarring. These products, which are still under research
Skin substitutes are a heterogeneous class of therapeutic devices that vary in their biology and application. Although there is no single perfect skin substitute, certain characteristics can be considered when evaluating alternatives. The product should be easy to prepare and apply without intensive training. The ideal skin substitute should induce repair without excessive scarring. It should reproduce both components of the skin (epidermis and dermis) and provide no antigenicity that could compromise the graft or host or present difficulties with future applications. Ellie Rahmani Neishaboor, Pharm.D., PhD., is a clinical pharmacist specializing in topical and transdermal drug delivery systems, and currently acting as regional pharmacy director for Rexall Drug Stores in BC.
References 1. B oateng JS, Matthews KH, Stevens HN, Eccleston GM. Wound healing dressings and drug delivery systems: a review. J Pharm Sci. 2008; 97(8): 2892-923.
4. T redget EE, Nedelec B, Scott PG, Ghahary A. Hypertrophic scars, keloids, and contractures. The cellular and molecular basis for therapy. Surg Clin North Am. 1997; 77(3): 701-30. 5. D ockery GL. Hypertrophic and keloid scars. J Am Podiatr Med Assoc. 1995; 85(1):57-60. 6. B anes AJ, Compton DW, Bornhoeft J. Biologic, biosynthetic, and synthetic dressings as temporary wound covers: a biochemical comparison. J Burn Care Rehabil. 1986;7:96-104. 7. S tern R, McPherson M, Longaker MT. Histologic study of artificial skin used in the treatment of full-thickness thermal injury. J Burn Care Rehabil 1990;11:7-13. 8. M achens HG, Berger AC, Mailaender P. Bioartificial skin. Cells Tissues Organs 2000;167: 88-94. 9. M etcalfe AD, Ferguson MW. Tissue engineering of replacement skin: the crossroads of biomaterials, wound healing, embryonic development, stem cells and regeneration. J R Soc Interface. 2007; 4(14): 413-37. 10. Ko FK. “Producing nanofiber structures by electrospinning for tissue engineering” in Nanofibers and nanotechnology in textiles: Woodhead Publishing; 2007. 11. Kumbar SG, James R, Nukavarapu SP, Laurencin CT. Electrospun nanofiber scaffolds: engineering soft tissues. Biomed Mater. 2008; 3(3): 034002. 12. Zhang X, Reagan MR, Kaplan DL. Electrospun silk biomaterial scaffolds for regenerative medicine. Adv Drug Deliv Rev. 2009; 61(12): 988-1006.
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CAREER OPPORTUNITIES
and committed to clinical pharmacy practice. This position may lead to a pharmacy manager position in the future as well as the potential for a partnership opportunity. Interested applicants are requested to send their cover letter and resume to spremji@forewest.ca. Only short listed candidates will be contacted for interviews.
ARE YOU MAXIMIZING THE VALUE OF YOUR MEMBER BENEFITS? Pharmacy members can place free Career Opportunities listing in these columns and on the web. General members looking for new career opportunities get free access to Hirea-Pharmacist. To learn more, log in and visit the Career Opportunities. The BCPhA Career Opportunities connects our members like no other job board, bringing member employers and potential employees together, and it is free!
COURTENAY
ABBOTSFORD Pharmasave in Abbotsford is looking for a part-time pharmacist. Weekends only. The pharmacy is located inside the new Abbotsford Regional Hospital. Remuneration paid according to experience. Contact Shaf or Shabita at 604.870.5600 or info@pharmasaveabby.com. ALDERGROVE In business since 1922, Otter Co-op is a successful $160M retail operation, located minutes east of Langley. Due to our tremendous growth and expansion plans, we are accepting applications for full-time pharmacy manager and full-time staff pharmacist. We provide an excellent pharmacy practice environment with personal growth and career development opportunities. Our benefit package includes extended health, pension contributions and a very competitive salary. If you are highly motivated to provide excellent pharmacy care and customer service, please apply to: Hisham Metwally, pharmacy manager, Otter Co-op, Box 4200, 3600- 248th Street, Aldergrove, BC. V4W 2V1. Email: pharmacymgr@otter-coop.com, fax: 604.856.3101. BURNABY Peoples Pharmacy #365 is currently looking for an experienced pharmacy technician. WinRx computer skills would be an asset. Work hours are Monday to Friday, 10am to 6pm with weekends off. Please call Al at 604.299.6677. BURNS LAKE Forewest Holdings is currently recruiting for a pharmacist for our Pharmasave location in Burns Lake. Burns Lake is located in northern BC and is an ideal location for a pharmacist interested in clinical pharmacy practice in a rural setting. It also provides easy access to numerous outdoor recreation activities. We are looking for a pharmacist with an entrepreneurial spirit that is detail-oriented
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Canada Safeway Limited currently has a career opportunity for a part-time pharmacist in Courtenay. If you are an experienced pharmacist who is licensed to practice in BC and looking to provide patient-focused care within a strong team environment, then this opportunity may be for you. We offer a full compensation and benefits package with industry-leading components. We are a company committed to both pharmaceutical care and customer care. If you would like to pursue this opportunity further, please send a cover letter and résumé by e-mail or fax to the address below: Christine Lee, BSc. Pharm., pharmacy recruiter, Canada Safeway Ltd. Phone: 604.301.2632, fax: 604.322.2508, Email: Christine.lee@safeway.com.
Clinic Drug Store - Looking for something more rewarding? Want to step away from the dispensary and spend more time with patients and provide clinical services like injections, medication reviews, smoking cessation counseling and more? This is an opportunity for a pharmacist who is willing to think outside the dispensary and move the profession to the next level. If you are looking for a challenge, then send your resume and a cover letter to clinicph@telus.net. Phone: 250.782.3104, fax: 250.782.8120. FORT ST. JOHN We here at Shoppers Fort St. John are looking for a full time/part-time pharmacist who thrives in a busy environment. The ideal candidate would be patient-oriented, able to multitask in a high script volume environment, and make medication reviews a daily focus. Starting wage is $54/hr and negotiable depending on experience. If you believe you are a suitable candidate, please email me your resume or call Irvin to discuss further details. Email: asdm274@shoppersdrugmart.ca, phone: 250.793.8413, fax: 250.787.0862
DAWSON CREEK
GIBSONS
Clinic pharmacy - just renovated. Looking for a smiling, passionate and seasoned regulated pharmacy technician with experience in BC to join our pharmacy. Goal is to free up pharmacists’ time so that more clinical services can be provided to patients. You must be able to work with minimal supervision, prioritize tasks, and provide excellent service to patients. Pharmacy is open Monday to Friday 9am5:30pm, Saturday 9am-1pm (except summer closed), no stats. Pay is based on experience and performance, $20-$28 per hour. Contact: Tenneille Metz, email: clinicph@telus.net, phone: 250.782.3100, fax: 250.782.8120.
Howe Sound Pharmacy in beautiful Gibsons, BC, is currently looking for a full-time/parttime clinical pharmacist to join our growing team of dedicated professionals. This is an ideal position for a pharmacist who is highly motivated to provide excellent pharmaceutical care and wants to extend the boundaries of good pharmacy practice to achieve better patient outcomes. We have licensed pharmacy technicians, which allows our environment to offer the fullest clinical services to our patients. We provide a unique practice environment with personal growth and professional development opportunities. Please contact John Shaske at johnshaske@telus.net.
Clinic Drug Store is looking for educated and trained full-time pharmacy technicians who have completed an accredited program (in BC preferred) in the last one to three years. Applicants should be working towards RPT designation. We are offering financial assistance to pay for PEBC for those candidates that commit to work for a minimum of two years. Applicant should be familiar with WinRx, PharmaCare policies, and third party billing. Shifts are between Monday to Friday, 9am-6pm. Pharmacy is closed Sundays and stats. We are looking to fill positions for September. Starting wage $16/hour. If qualified, please send resume by email to clinicph@telus.net. Phone: 250.782.3100, fax: 250.782.8120.
www.bcpharmacy.ca
KAMLOOPS Manshadi Pharmacy is the only true independent pharmacy in Kamloops. We are looking for a full or part-time pharmacist who is looking to thrive in an environment which focuses on personalized patient-based care. We offer a positive work environment, encourage professional growth, and are closed weekends and holidays. Please send resumes to: Missagh Manshadi via email: missagh@manshadipharmacy.com. Only successful candidates will be contacted.
CAREER OPPORTUNITIES
OKANAGAN
PORT COQUITLAM
Canada Safeway Limited currently has a career opportunity for an Okanagan float pharmacist. We offer a full compensation and benefits package with industry-leading components. We are a company committed to both pharmaceutical care and customer care. If you would like to pursue this opportunity further, please send a cover letter and résumé by e-mail or fax to the address below: Christine Lee, BSc. Pharm., pharmacy recruiter, Canada Safeway Ltd. Phone: 604.301.2632, fax: 604.322.2508, email: Christine.lee@safeway.com.
Pharmasave in Port Coquitlam is looking for a part-time pharmacist to join our team. The ideal candidate will be self motivated and possess excellent communication skills. Prior knowledge of Kroll, compounding experience, injection training certification and compression stocking fitting would be an asset. We are a community based pharmacy focused on customer care. If you would like to be part of our pharmacy team please email your resume in confidence to Darin Fenton at ps190job@telus.net. SECHELT
PENTICTON Full-time staff pharmacist/pharmacy manager: excellent compensation and benefits plan, relocation allowance, ongoing 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 contact Kay Sajid at kay.sajid@loblaw.ca, phone 1.905.216.6010, fax: 1.866.628.5329, www.drugstorepharmacy.ca. PORT ALBERNI Canada Safeway Limited currently has a career opportunity for a part-time pharmacist in Port Alberni. If you are an experienced pharmacist who is licensed to practice in BC and looking to provide patient-focused care within a strong team environment, then this opportunity may be for you. We offer a full compensation and benefits package with industry-leading components. Please send a cover letter and résumé by e-mail or fax to the address below: Christine Lee, BSc. Pharm., pharmacy recruiter Canada Safeway Ltd. Phone: 604.301.2632, fax: 604.322.2508, email: Christine.lee@safeway.com. Canada Safeway Limited currently has a career opportunity for a part-time registered pharmacy technician. We offer a strong team environment; this opportunity may be for you. We are a company committed to both pharmaceutical care and customer care. Please send a cover letter and résumé by e-mail or fax to the address below: Christine Lee, BSc. Pharm., pharmacy recruiter Canada Safeway Ltd. Phone: 604.301.2632, fax: 604.322.2508, email: Christine.lee@safeway.com.
Full-time staff pharmacist: 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 contact Kay Sajid at kay.sajid@loblaw.ca, phone 1.905.216.6010, fax: 1.866.628.5329, www.drugstorepharmacy.ca. SURREY Pharmacy manager and part-time pharmacist needed for independent community pharmacy. Friendly environment, flexible shifts and no evenings. We offer a competitive wage. Must be able to work some weekends. New grads welcome! Please fax your resume to 604.543.4433. Tel: 604.543.6677. TSAWWASSEN Tsawwassen Pharmacy is looking for an experienced part-time or full-time pharmacist to join our team. The ideal candidate will be self motivated and possess excellent communication skills. Injection training certification, compression stocking fitting, nursing home experience and prior knowledge of ARI WinRx would be an asset. We are located in a medical building with focus on customer care and service. We have excellent clientele and working environment. No Sunday or evening shifts. We offer a competitive compensation package. If you would like to be part of our pharmacy team, please email your resume in confidence to Edwin Lee at edwinlee@shaw.ca. VANCOUVER Part-time pharmacist position available immediately. Shoppers Drug Mart Pharmacy is
www.bcpharmacy.ca
located at 3303 Main St, Vancouver BC, V5V 3M8. Please contact Henry, 778.328.9580 or email “Associate SDM2252” at asdm2252@shoppersdrugmart.ca. Full-time pharmacy technician required. You have pharmacy work experience and are fluent in Cantonese and Mandarin. We are a small pharmacy, with a steady flow of prescriptions so there will be frequent interactions with patients in person and on the phone. You will help the pharmacist dispense medications, blister pack medications, maintain inventory, keep the pharmacy organized and clean, and you will use the cash register. There will be administrative duties, some filing and simple accounting. Hours are: Mon to Fri, with no evening shifts. Saturday morning shifts may be required and that will be discussed. Email: vancouverpharmacyjob@hotmail.com. A full-time pharmacist /pharmacy manager position available at The Chemist pharmacy in Vancouver. We are offering competitive wage and full benefit package. Email: mehdi@thechemist.ca, phone: 604.928.3837, fax: 604.630.2351. Part-time pharmacist needed for an independent pharmacy in Vancouver. No Sundays or evenings required. Cantonese speaking is an asset. If interested, please contact Mary, phone: 604.683.6381, fax: 604.683.8623. PharmD or pharmacist with strong clinical skills is sought for community medication reviews in Vancouver and the North Shore. Candidate should have excellent interpersonal communication, be organized, have leadership qualities and be a critical thinker. Candidate must be hard working, have strong time management skills, be solutions driven and capable of working in a fast pace environment. This position is split between clinical and dispensing with emphasis on the clinical component. Interested candidates can apply to amin@cheos.ubc.ca, Pharmax Health Inc. Peoples Drug Mart in Champlain Square Vancouver is looking for a pharmacy assistant to work part time (approximately 12 hours a week) with some additional hours to cover vacations and clinic days. If interested, please contact the pharmacy manager by email: kim.pdm168@pdmstores.com. No walk-ins or phone calls please. VICTORIA Rexall Pharmacy is looking for a fulltime pharmacist for our long term care facility. Katz Group Canada Ltd. is Canada’s leading integrated retail pharmacy network
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Pharmacist required to work at the UVic Campus Pharmacy, Shelbourne Plaza Pharmacy and Cadboro Bay Compounding Pharmacy, owned and operated by Naz Rayani. We are looking for an engaged, clinically oriented outgoing, full-time pharmacist to work at our unique community pharmacies. Our focus is on patient-centered practice with a desirable and friendly population. All applications are confidential. Compensation is commensurate with experience. Please submit applications to jobs@victoriapharmacy.com. Pharmacy technician required to work at the UVic Campus Pharmacy, Shelbourne Plaza Pharmacy and Cadboro Bay Compounding 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 submit applications to jobs@victoriapharmacy.com. Forbes Pharmacies are a local success story, located in beautiful Victoria, now accepting resumes for part-time and full-time pharmacists to join and add to our success. When you join The Forbes Pharmacy Group you become one of the family. We work hard and well as a team. Your strengths and passions are recognized. We offer a competitive salary and benefits package, and full pharmacy technician coverage. Please submit your CV along with cover letter to Forbesâ&#x20AC;&#x2122; President, Mike Forbes, at mforbes@forbespharmacy.ca. WEST VANCOUVER A Pharmasave in West Vancouver is seeking a friendly, outgoing, reliable pharmacy technician to provide superior customer service. Duties will include greeting customers, receiving prescriptions & obtaining relevant information, compounding, compliance packaging, processing cash and other duties as required. Previous pharmacy technician experience or recent graduation from a pharmacy technician program is mandatory. Good interpersonal and computer skills are essential. Excellent written and spoken English are compulsory. Experience with Kroll is beneficial but not required. We offer flexibility, an enjoyable working environment and competitive wages. Please
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send resume to Roberto at pharmacist@prvpharmasave.com OPPORTUNITIES ACROSS BC FOREWEST HOLDINGS - Pharmacists are needed for various Forewest Holdings locations across BC. We are currently looking for pharmacists to join our rapidly expanding company. Forewest Holdings operates 30 locations in BC and Alberta and we will be expanding in the near future. To facilitate our expansion plans, we are interested in hiring pharmacists that are committed to clinical pharmacy practice in the community setting and possess an entrepreneurial spirit. Pharmacists interested in developing their skills to grow a pharmacy business in an independent environment are encouraged to apply. Pharmacists should be team players. We are looking for pharmacists who are committed to building relationships with customers and physicians and who will work hard to make their store a destination for health and wellness information. If you are interested in joining our dynamic company, please send your resume to spremji@forewest.ca. LONDON DRUGS is accepting applications for pharmacist positions throughout BC. Pharmacists will have the opportunity to be involved with various patient care initiatives offered at London Drugs such as INR monitoring, long term care, certified diabetes education, immunization and various clinics such as osteoporosis screening, heart health, diabetes, sun and smoking cessation. We offer competitive salary and benefit package, moving allowances, professional working environment, scheduled meal breaks, semiprivate counseling booths, automated robotic dispensing machines and employee discounts. Please apply in confidence to: Shawn Sangha, B.Sc. (Pharm), London Drugs Ltd. pharmacy operations manager, BC. Tel: 604.272.7469, fax: 604.448.1075, e-mail: ssangha@londondrugs.com. OVERWAITEA FOOD GROUP - consisting of Overwaitea Foods, Save-On-Foods, PriceSmart Foods, Urban Fare and Coopers Foods are hiring. Staff pharmacist positions are available in 100 Mile House, Campbell River, Chilliwack, Cranbrook, Creston, Fort Nelson, Grand Forks, Kelowna, Kitimat, Parksville, Prince George, Quesnel, Squamish, Terrace, Williams Lake, Fort McMurray, Red Deer and Lethbridge in Alberta. Relief pharmacist floater positions and pharmacy technician positions in BC and Alberta are also available. We provide an excellent pharmacy practice environment with personal growth and career development potential. Very competitive wages and benefits
www.bcpharmacy.ca
GIG3135
encompassing more than 1,800 corporate, franchise and independent pharmacies. 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 opportunity, full benefits package, educational allowances, paid med. checks, career growth opportunities. Please send resumes to njoshi@rexall.ca, thank you.
Anyone can make an error. Protect yourself. Preventing dispensing errors and the potential injuries to clients is the focus of this educational series. To help you understand and deal with these issues, Grain Insurance and Guarantee Company has commissioned a series of articles from Ms. Marie Berry, B.A., B.Sc. (Pharm), LL.B. Ms. Berry is a pharmacist and lawyer specializing in health care law. You can find her article at http://graininsurance.com/ pharmacy/page_bcpa.html For more information about the specialized insurance products that can protect all youâ&#x20AC;&#x2122;ve worked for, contact Stephen or Stuart Adams at 604-251-3571 or 1-877-251-4079, or email pharmacy@theadamsgroup.ca
CAREER OPPORTUNITIES ASSOCIATION CONTACTS
including a pharmacist incentive plan. We thank all applicants, however only shortlisted candidates will be contacted. Contact: Chi Quon, regional pharmacy manager, 604.881.3574, fax: 604.882.7896, chi_quon@owfg.com, www.saveonfoods.com. PEOPLES DRUG MART and Peoples Pharmacy have several locations throughout beautiful British Columbia offering a desired combination of employment opportunity and unbeatable lifestyle. Contact: Smita Natha, professional services manager, Peoples Drug Mart, 5204400 Dominion Street, Burnaby, BC. V5G 4G3 Tel: 604.431.3595 ext. 26, fax: 604.431.3596, email: smitan@pdmstores.com.
THRIFTY FOODS - Bring your professionalism and your dreams to Thrifty Foods new frontier and become an important part of our company as we grow together. Pharmacy manager and staff positions available. Thrifty Foods Pharmacy is committed to offering a comprehensive pharmacy service to these communities. Competitive wages and benefits. Interested candidates are invited to submit their resumes to Nafeesa Shaikh, pharmacy recruitment and retention specialist, Sobeys Pharmacy Group. Toll Free #: 1-800-790-0733 x. 7704, phone #: (902) 468-1000 x. 7704, fax #: (877) 662-1955. BUSINESS OPPORTUNITIES
REXALL- Since 1904, Rexall has been a trusted name in retail pharmacy. Rexall is also the flagship pharmacy for Katz Group Canada, a leading drug store company and the largest integrated retail pharmacy network in Canada, with more than 1,800 corporate, independent and franchise pharmacies across the country. As the umbrella brand for a family of pharmacies including the Rexall, Rexall Pharma Plus, The Medicine Shoppe, Guardian and I.D.A. banners, Rexall is dedicated to the health and well-being of our customers and patients and strives to provide the best possible pharmacy care in a pharmacy first environment. Our long term care pharmacists and pharmacy technicians provide highly specialized clinical and medication management services for residents of nursing homes, retirement residences, assisted living facilities and group homes through dedicated pharmacies. If you are interested in applying or would like to learn more about the opportunities we have, please visit our website at www.rexallcareers.ca or contact a member of our team: Neerav Joshi, pharmacy recruitment manager njoshi@rexall.ca.
At PHARMASAVE we understand that you want to be in business for yourself, not by yourself. You can have the best of both worlds! Maintain your freedom and independence while having access to the most comprehensive retail and professional programs in the industry. Pharmasave’s proven products, programs and strong national brand are always at your service. Pharmasave is unlike any other independent pharmacy venture in Canada. We are a true cooperative that is 100 per cent member owned and governed. With Pharmasave, not only do you benefit from owning your own business, but you also share in the economic advantages of a 400+ strong group of stores. Plus, you will be an owner in an organization that delivers all of its profits directly back to you, the shareholder. Allow us to demonstrate the advantages of Pharmasave. If you are a store owner or a pharmacist interested in purchasing a pharmacy, or if you are planning on selling your business, please give us a call. Pharmasave’s only priority is you and your success! Contact: Dave Reston, CEO, Pharmasave Pacific, tel: 604.575.5730 or 1.800.665.3344, dreston@pharmasavebc.ca.
SHOPPERS DRUG MART is one of the most recognized and trusted names in Canadian retailing. The Company is the licensor of fullservice retail drug stores operating under the name Shoppers Drug Mart (Pharmaprix in Québec). With more than 1,000 Shoppers Drug Mart and Pharmaprix stores operating in prime locations in each province and three territories, the company is one of the most convenient retailers in Canada. At Shoppers Drug Mart, we have always remained true to our belief that the root of our success lies with our people. We pride ourselves on the quality and commitment of our employees who thrive on exciting challenges.
Port Alberni - A super community pharmacy for sale. Viable Rx department. Price will include 2700 sqft. strata lot. Easier financing if required. Alberni Valley economy is on rebound. Tel: 250.723.9323, fax: 250.723.8221.
Geraldine Vance Chief Executive Officer 604.269.2860, Geraldine.Vance@bcpharmacy.ca Parkash Ragsdale Deputy CEO, Director, Professional Services 604.269.2862, parkash.ragsdale@bcpharmacy.ca Cyril Lopez Chief Operating Officer 604.269.2869, cyril.lopez@bcpharmacy.ca Kathie Taylor Director, Communications 604.269.2863, kathie.taylor@bcpharmacy.ca Elise Riedlinger Manager, Communications 604.269.2866, elise.riedlinger@bcpharmacy.ca Vince Lee Manager, Member Services 604.269.2867, vince.lee@bcpharmacy.ca Bryce Wong Manager, Professional Services 604.269.2865, bryce.wong@bcpharmacy.ca Riva Pickering Coordinator, Professional Services 604.269.2880, riva.pickering@bcpharmacy.ca Letlotlo “Coco” Lefoka Public Affairs Officer 604.269.2868, coco.lefoka@bcpharmacy.ca Linda Tinnion Assistant, Member Services 604.269.2864, linda.tinnion@bcpharmacy.ca Ray Chow Database Administrator Member & Corporate Services 604.267.7081, ray.chow@bcpharmacy.ca Emilija Stanic Executive Assistant 604.269.2861, emilija.stanic@bcpharmacy.ca Starr Rempel Receptionist and Administrative Assistant 604.261.2092, starr.rempel@bcpharmacy.ca 604.261.2092, Toll-free: 1.800.663.2840 info@bcpharmacy
Are you thinking of selling your pharmacy? OVERWAITEA FOOD GROUP may be interested. If you would like more information contact us at pharmacybuyer2012@gmail.com. Listings have been edited for brevity – for complete job postings please visit www.bcpharmacy.ca
www.bcpharmacy.ca
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BC Lions Canucks Car rental Cineplex Hotels around the world PNE and Playland Show tickets and much more!
Affinity BCPhA prescribed member discounts
Introducing our newest Affinity Rx partner!
iPhone, Blackberry, Samsung and other smartphones available through the BCPhA website, starting the end of Sep 2012.
179
$
iPhone 5 available through the BCPhA website.
with a 3-year contract
And receive a $ 150 bill credit*
*Sign-up for a new 3-year voice & data plan activation with any iPhone, smartphone or Blackberry on the BCPhA Telus program and we will credit your BCPhA Telus bill with a $150 credit! Also, we will waive the $35 activation fee! To find out if you are eligible and for all the details, please visit our website at www.bcpharmacy.ca/telus
Fully loaded voice & data plan
$
50
per month**
**Plus HST. There are no system access fees or 911 fees, so the typical bill will be $56 per month.
● 300 anytime minutes ● Unlimited evenings after 6pm ● Unlimited weekend calling ● Unlimited network calling ● Unlimited national text messaging ● Voicemail 10, caller ID, call conference, call waiting, call forwarding ● 1GB data across Canada ● Tethering included ● Discounted long distance, additional airtime and extra data
www.bcpharmacy.ca/telus
Questions? Contact Vince Lee vince.lee@bcpharmacy.ca 604-269-2867