Your friendly neighbourhood clinical pharmacist: More than just complex medication referrals

When to refer patients to Burnaby Primary Care Network’s clinical pharmacist services

Burnaby Primary Care Network (PCN) clinical pharmacists work alongside family physicians and nurse practitioners to help your patients make informed, evidence-based choices about their medications.

Complex medication reviews may be the first thing that comes to mind when you think about referring to the clinical pharmacists—but their support extends to many everyday medication questions, too. Sharing care with a clinical pharmacist gives you more time to address other priorities during appointments, while ensuring patients get the medication support they need.

Here are some ways a PCN clinical pharmacist can help:

1. More time for medication questions

• Some patients benefit from additional time to discuss possible side effects, ask questions about information they’ve read, or work through medication instructions
• A clinical pharmacist can explain information in different ways and help patients feel more confident about their medications

2. Chronic disease management

• Disease states that require more education and follow-up
  • Examples: T2DM and insulin initiation, titration, CGM follow up, and adherence
• COPD: Personalized COPD action plans and review of inhaler-technique

3. Affordability and PharmaCare education and navigation

• Patients on income assistance or have limited resources
• New to the country who needs medication coverage
• Their circumstances have changed such that they no longer have third party coverage. Do they need to register for Fair Pharmacare? What is their family deductible? What about the National Pharmacare plan?

4. Sleep and benzodiazepine tapering

• Patients who may benefit from sleep-hygiene counseling and reducing reliance on benzodiazepines
• Slow taper of benzodiazepines

5. Smoking cessation

• Personalized quit plans and medication options

6. Unresolved symptoms or lingering adverse effects

• You’ve gone through your differential but haven’t had time to review all their medications. Could these symptoms be due to medications?

7. Chronic kidney disease and renal dose adjustments

• Your patient’s GFR has just dipped below 60ml/min. Consider a review of all the medications for renal dose adjustment to reduce risk of adverse effects

8. Drug interactions and drug level monitoring

• You get notification from a pharmacy that there’s drug interactions and not sure how to manage.
• Drug level monitoring and assessment required
  • Examples: phenytoin, valproic acid, carbamazepine levels
• Really labile INR and/or patient has a higher INR target 2.5-3.5 requiring thorough assessment

9. Natural and herbal health product questions

• Patients who prefer natural medicines and alternative health approaches. What is the evidence? Are these safe? Will they interact with prescription medications?

10. Polypharmacy and deprescribing

• Patients taking more than 10, 20, 30+ medications and considerations for de-prescribing and simplification

11. Recent hospital discharge

• Medications have changed and requires medication reconciliation
• Concerned that patient isn’t following the discharge prescription

A simple referral can make a big difference in managing your busy practice. Sharing care across the team can help patients get the education, follow-up, and medication support they need, while supporting your ongoing care.

How to refer

• If a Burnaby PCN clinical pharmacist works with your clinic (co-located clinics): Please speak with your Burnaby PCN Clinical Pharmacist.
• For referrals through Central Intake: Complete the consolidated Burnaby PCN Referral Form and fax it to 604-398-8257. The form is available in OSCAR, MYLE and Med Access EMRs, as well as on the Burnaby PCN website and Pathways.

Interested in having a Clinical Pharmacist Co-Locate in your Office?

Burnaby PCN Clinical Pharmacists can work with clinics through virtual or in-person co-location arrangements. If you are interested in a co-location model, please contact Georgiana Ioica, the PCN Optimization Manager, Operations and Systems, at burnabypcn@burnabydivision.ca.

Meet your Burnaby PCN Clinical Pharmacists