Over the last couple of decades, the role of pharmacists has evolved significantly. Canada’s pharmacists have become a front-line resource to provide comprehensive advice about medications and healthy lifestyle choices, to teach, to flag potential interactions, to give vaccinations, and to help patients keep on track with their treatments for a range of diseases and conditions. Pharmacy professionals work alongside doctors as a team to ensure patients receive the most effective care. For those concerned with preventing osteoporosis and its treatments, this is a critical dynamic.
“Before, pharmacists were viewed only as pill dispensers,” says Rami Al-Akhrass, pharmacist/owner of Pharmacie Al-Akhrass and Romano, in Montreal. “They would see a prescription from the doctor, fill it, and give it to the patient. That was it. Now we’re more involved in the process. We have more of a clinical approach. We don’t just focus on the medication. We ask, ‘What is the diagnosis?’ and ‘Does the patient take the right medication for it?’”
Pharmacists get to know their clientele in a different way than physicians do. As Al-Akhrass explains, they see people regularly, perhaps weekly or monthly. That helps to build personal knowledge useful for providing the most-fitting guidance and services. “Pharmacists will take a few minutes to chat with customers, to ask them about their health habits, what they eat, what they drink,” he says. “We are aware of their file. We know if they have a history of, or are prone to, bone fractures. We’re very close to them. That’s the key with a pharmacist. We can be the bridge between patients and the doctor. I think that’s the role of the pharmacist.”
For some osteoporosis patients, those needs may include support with medications that strengthen and rebuild bone after a fracture occurs. These drugs come in pill form available through a pharmacy or as an injectable medication given once every six months. Most patients go to their physicians to get their shots, but some are turning to their pharmacists to learn how to self-inject or to have them administer the shot with a medical directive from their doctor – a convenient option, especially during COVID when access to medical appointments has been limited. It’s an option that osteoporosis patients should be aware of, and their caregivers, too.
“We can be the bridge between patients and the doctor. I think that’s the role of the pharmacist.“
“Many patients are not comfortable injecting themselves,” explains Al-Akhrass. “They’re scared that they’re going to do something wrong or to do the injection incorrectly. But we teach them the right way and help them feel confident about doing it.” He sets aside 30 minutes for each appointment with clients to provide them with plenty of time for detailed instruction. In the future, they can return to the pharmacy to self-inject with a pharmacist present for support.
Pharmacists are well-educated about injections. In Ontario, pharmacists take specialized injection training courses through organizations, such as the Ontario Pharmacists Association. If directed by a physician, those who have taken that training may inject patients with osteoporosis medication – a service available by appointment. Each province sets its regulations and requirements about what type of injections a pharmacist is allowed to give. They differ across Canada. For example, a Quebec pharmacist is not permitted to inject osteoporosis medication but may provide instruction to patients on how to self-inject. Ask your pharmacist about what services are available to you locally.
Continuity of care is also top of mind for pharmacists. It’s essential for those who have been prescribed osteoporosis medication to adhere to the treatment plan outlined by their doctors. Skipping or delaying doses can have serious consequences. “With injectable osteoporosis medication, if you skip it, it’s like you never took it at all,” says Al-Akhrass. Injections need to be repeated every six months. Poor adherence to the schedule negatively impacts bone density gains, according to a study published in The Journal of Clinical Endocrinology & Metabolism.
Pharmacists, like Al-Akhrass, check their client files continuously so that injections are not missed. They will reach out with a reminder call to ensure injections are not skipped or delayed. It’s another part of what it means to be a trusted part of someone’s healthcare team – providing support, knowledge, and education.
As Al-Akhrass points out: “Customers often call us before calling their doctors because we are accessible and easy to reach… If they can walk into the pharmacy, we’re going to be able to talk to them in a matter of minutes. They value our knowledge. We are experts who have studied medications for four years or more. At the end of the day, the goal for all of this is that every patient receives the best care possible.”
Draw on the expertise offered by your pharmacist and your doctor – your partners in bone health. Talk to them about osteoporosis risk factors, fracture prevention, bone density tests, osteoporosis treatment options, and ways to build and maintain bone strength.
Did you know?
If you’re an osteoporosis patient being treated with an injectable medication, you have choices available about how to receive your shot:
1️⃣ Have your injection at your doctor’s office.
2️⃣ Book an appointment with your pharmacist to learn how to self-inject at home.
3️⃣ Talk to your pharmacist about getting your shot at the pharmacy. (Provincial guidelines vary.)
Supported through a Sponsorship by Amgen Canada Inc.