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District 3 - Hafeez dossa
As a pharmacy manager involved in servicing over 5 residential care facilities across Vancouver Island, I have had the opportunity to learn about the specific needs of LTC residents. This area of care is one that many do not have an opportunity to engage in, and I feel my experience in this setting will help the College and its registrants improve the quality of pharmacy services these residents receive. As our population ages, and the need for optimal medication management for very elderly patients will undoubtedly increase, having input from a pharmacist with this type of experience will be vitally important in ensuring the needs of these residents are considered in regulatory discussions with the College.
To give a quick snapshot of what our work is all about in LTC, I figured to give a brief summary of my role at these facilities. Through care conferences and medication reviews, I have found an interest in the practice of de-prescribing. For all residents in LTC, the goal of therapy is comfort care and maintaining an optimal quality of life, as life expectancy, once admitted, tends to be about 2 years. It is extremely common for patients to be admitted to our facilities on an extensive list of medications, and experience “prescribing intertia,” where they continue on drug therapy that may no longer be appropriate. As pharmacists, we help improve the utilization of medications, and I thoroughly enjoy consulting with the interdisciplinary team to ensure we are recommending safe, effective, and appropriate drug therapy.
With this goal in mind, I have taken the initiative on a project re-assessing the need for PPI’s (Proton Pump Inhibitors) in our residents. I have found that approximately 20-25% of residents in our homes use PPI’s, and of these almost 50% don’t have an indication. Although effective medications, with long term use of PPI’s there is an increased risk of infection, fracture, and impaired vitamin/mineral absorption. Also of importance is that occasionally, PPI’s may not be covered under drug plans and would incur a cost to the resident. After evaluating the charts of over 500 residents, we were able to successfully implement de-prescribing in over 60% of residents, and in turn reduce the costs to BC Pharmacare, reduce pill burden on patients and nursing, and finally improve the utilization of medications in a patient population that is often forgotten about. This is the type of work that needs to happen throughout our province, and as a member on the Board of the College of Pharmacists of BC, I will bring this fresh perspective in the decision making that occurs on a regulatory level.
In this role, I hope to have the opportunity to learn from other pharmacists in different areas of care, and bring an important new perspective on the issues pertaining to residents in an LTC facility. I am excited to see how we, as a College, can further support registrants working in this setting to maintain, and improve, our standard of care in this setting.