Saturday, October 24, 2020

Let’s Talk. How To Break The Ice With Your Pharmacist And Start A Conversation About Bone Health

Have you talked to your pharmacist lately? Why not? If you need professional advice about bone health, you may be missing out on an invaluable resource that can support those concerned about, or living with, osteoporosis. Pharmacists are readily available to assist you with a range of services and expertise, from guidance about vitamin D supplements to on-site injections of medication to treat the disease. 

Dr. Vivien Brown

Physicians also recognize that pharmacies are partners in osteoporosis care. Dr. Vivien Brown, a family physician and assistant professor, department of family and community medicine, University of Toronto, treats pharmacists as part of the healthcare team. “A pharmacist knows when a drug was renewed, and if it wasn’t and should have been. Pharmacists have an understanding of the multiple medications people are on and which ones may be bad for bones.”

Two common drugs that can weakened bones are selective serotonin reuptake inhibitors (SSRIs) and proton pump inhibitor (PPIs). As Dr. Brown points out, a psychiatrist may have prescribed an SSRI medication to treat depression, or a gastroenterologist may have written a prescription for a PPI to address heartburn and acid-related disorders, not a family doctor. 

Doctors and pharmacists partners in health

“Sometimes a pharmacist has a better overview of all the medications that a given patient is using,” she says. “As the pharmacist looks at their drugs, he may be able to say, ‘you’re also on medication for osteoporosis. You should review this with your doctor. When were you last evaluated?’ The pharmacist’s role in terms of knowing which drugs have an impact on bones and knowing the full picture of what a given patient is on could be very helpful.”

When it’s not possible to see your doctor right away, your local pharmacy is there to help. “You could walk up to the pharmacist and talk about something without an appointment,” she says. “That’s done on the spot. Pharmacists have an accessibility advantage and there’s also trust. I do think pharmacists are part of the healthcare team in a serious way.”

During COVID, physicians were less readily available than they were before. Pharmacists stepped up in a big way to assist osteoporosis patients. “We made sure those being treated for osteoporosis continued to receive care,” says Scott McDonell, pharmacist and owner of Remedy’s Rx Pharmacy – Williamsburg (and three other locations also in the Kitchener-Waterloo area). 

“We did a lot more injections for patients because doctors weren’t in their offices to do them. We were able to provide a continuity of care so I think that was a huge benefit. Sometimes it was overwhelming, but we did everything possible to ensure everyone stayed safe.”

Safety is on the minds of everyone these days. Pharmacists, too. They’ve been able to put protocols in place where you can get in and out quickly to get your shots. If you’re on injectables to treat osteoporosis, talk to your pharmacist about how they can save you a trip to your doctor’s office. A pharmacist has the expertise to teach you how to self-inject and can administer the shot for patients when directed to do so by a doctor via a notation on the prescription.

“Pharmacists have an accessibility advantage and there’s also trust. I do think pharmacists are part of the healthcare team in a serious way”

Understanding patients’ needs

 As Dr. Brown mentions, pharmacists can see a patient’s big picture. That’s why a MedsCheck, a complete review of your medications, is so helpful. McDonell suggests booking an appointment once a year, especially if you are on three or more meds. If you’ve been diagnosed with a new disease condition, you may want to discuss your medications sooner with your pharmacist. 

It’s a good way to get to know them and vice versa: “When you sit down for a full MedsCheck, we look at things like smoking, alcohol intake, past fractures and family history, and your current situation. It gives us an opportunity to say, ‘You know what? You might be at risk of osteoporosis. Have you talked to your doctor about that?’ That can prompt a conversation about bone health.”

McDonell also points out that you can do less formal med checks at any time. “I’m happy just to converse at the counter about what is needed and not needed,” he says. “We chat frequently with patients in the aisles about their concerns. That’s what we’re here for.” PULL QUOTE He also recommends sticking to one pharmacy: “I think you want to develop a rapport with your pharmacist. You’ll be better covered. They will know right away what things may be better or or not better for you.”

If you’re looking to build the best healthcare team possible, make sure you include your pharmacist, a partner who is there to support your quest for bone health and beyond.

5 key questions to ask your pharmacist about osteoporosis 

  1. Am I at risk of osteoporosis? Based on your medications, a pharmacist can flag any that may compromise bone health and suggest proactive measures. They can also let you know when it may be time to contact your doctor about scheduling a bone density test.
  2. Am I at risk of osteoporosis? Based on your medications, a pharmacist can flag any that may compromise bone health and suggest proactive measures. They can also let you know when it may be time to contact your doctor about scheduling a bone density test.
  3. What services do you have that will help me manage osteoporosis? Your pharmacist can talk about options for those on injectable medication, including teaching you how to self-inject or doing the injection for you.
  4. Can we review the medications I’m on? Pharmacists are happy to book a MedsCheck and identify any areas of concern.
  5. What kind of supplements should I take? An informal stand-up consultation can provide the right kind of guidance to ensure you’re getting the right amount of vitamin D and calcium for strong bones. A pharmacist can also make suggestions on how to improve their absorption.

Supported through a Sponsorship by Amgen Canada Inc.

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Feel It In Your Bones
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Feel It In Your Bones is a new campaign from Amgen Canada and YouAreUNLTD to raise awareness of good bone health.