The Role of Pharmacy in the Health Populations

Question 1

What is pharmacies public health role

Answer 1

Traditionally it is quite limited and still being defined
1. Immunization
2. Emergency preparedness
3. Family planning services
4. Prevent and control disease and injury

Question 2

4 ways pharmacies participate in public health (explain)

Answer 2

1. Immunization
   
   • Promote vaccination programs: Passive: signage and pamphlets informing patients and others of health issues and risks, Proactive: identify at risk people from medical profiles and target them when they come in
   • Administer vaccinations: more cost effective then physician administered programs, also more convenient and accessible then nurse led
     2. Emergency preparedness
   • Store and give critical medicines and other healthcare supplies
   • Early recognition of unusual disease/ conditions (have info such as changes in OTC sales that can inform the health system)
     3. Family planning services
   • Support womens health and choice through: information/ referrals, timely access to emergency contraception, timely access to effective abortifacients
     4. Prevent and control disease and injury
   • Prevention (eg. Sale of condoms to reduce STIs), behaviour modification(smoking cessation clinics) early detection of disease

Question 3

Barriers to participation by pharmacists in public health

Answer 3

1. How does the physical design of the pharmacy effect perception
   
   • More accessible then other professions but feels commercialized and can hinder the public health image
   • Public is willing to consult with pharmacists but need to ensure they are made aware of expertise and willingness to provide them services
   • Need a space for private consulting, health literature is up to date
     2. Lack of information/ training
   • Most is focused on acute care and treatment rather then enhancing overall wellbeing or prevention
   • Little time spent on public health issues and solutions
     3. Time constraints
   • Pharmacists are being constricted by a growing volume of prescriptions and expanding hours of services
   • Hard to justify giving higher priority to non traditional activities such as changing patient behaviour
     4. Lack of reimbursement
   • Product focussed profession (paid to dispense)
   • Health promotion and disease prevention tend to not be covered
     5. Lack of management support
   • Pharmacy is a business and dominated by non-pharmacists owned chains
   • Nature of pharmacy practice is dictated to a great degree by the one in power

Question 4

HIV/AIDS in canada

Answer 4

• Has an intermediate number of cases in comparison to other contries (68,000 people in 2018, <0.2% of pop)
  It carries a stigma and many of those affected are socially marginalized (sex workers and PWID)

Question 5

Rates of HIV/ AIDs in canada

Answer 5

infection rates among PWID: 8.3% of all new infections
The rate of infection among PWID is 59 times higher then the general population

Question 6

Need for a public response in relation to HIV/AIDS

Answer 6

• Use strategies for targeting exposure and transmission of HIV (change behaviours to reduce risk, promote technologies that prevent sexual and blood-borne transmission
  
  • Need to implement these in a confidential and anonymous manner

Question 7

How can we help with HIV/ AIDS

Answer 7

• First step is to stop judging
  
  • Accept that PWID are not likely to stop in the short term or maybe ever
  • Focus on encouragement in safer sex and drug use practices

Question 8

Principles of harm reduction in association with PWID

Answer 8

• The main goal is to reduce harm rather then drug use
  
  • Accept that drugs are apart of society and will never be gone
  • Priority is placed on immediate and achievable goals
  • Underpinned by knowing every life matters and everyone should be treated the same and with respect

Question 9

What are IDU harm reduction strategies

Answer 9

• Information and counselling of the safe use of needles and syringes
  
  • Needle exchange programs
  • Safe injection sites
  • Counselling on safer sex practices
  • Methadone clinics
  • Referrals to social services
  • Naloxone and drug assay kits

Question 10

Barriers to access with PWID

Answer 10

• Limited success as those who adopt harm reduction strategies have poor access due to limited number of programs and limited hours, sources of clean needles are not really accessible at night when they use drugs
  
  • Require persistent outreach

Question 11

Role for community pharmacy in relation to HIV/Aids

Answer 11

• Open display and sale of condoms and other safe sex products
  
  • Counselling on safe sex practices
  • Selling and counselling on safer drug injection equipment
  • Giving a site for the safe disposal of used equipment
  • Give source for naloxone and drug assay kits
  • Dispensing methadone

Question 12

Pharmacies initial response to HIV/AIds

Answer 12

• Ealry 1990s They discouraged the sale of needles and syringes as it was viewed as unprofessional and there were sanctions if you did sell
  Late 1990s provided more services such as on site used syringe disposal services (56%), bleach kits for sterilization (65%) but only 1/3 participated in exchange programs.

Question 13

Harm reduction in the mid 2010s for HIV/ AIDS

Answer 13

• Ongoing scope of pharmacies professional role (limited role but expanding)
  
  • Potential conflicts and concerns: concerns about training, more workload and money paid to them. Concerns about impact of more of a presence of PWID within and in proximity to the pharmacy