Pharmacist Awareness Week - Pharmacists Manitoba · Ask any pharmacist that has been around long enough, and they will tell you that these things always go in cycles. “There were

The Last Word …Waiting For Help:Pharmacists Are Being Pushed To Health Care’s Front Lines

Continuing Education:Therapeutic OptionsFocus on Oral Contraceptives

VOL. 30, NO. 3 January/February 2005

A PUBLICATION OF THE MANITOBA SOCIETY OF PHARMACISTS INC.

Publication MailAgreement No. 40013710

Return Undeliverable Canadian Addresses To:

The Manitoba Society of Pharmacists202–90 Garry St.Winnipeg, MB R3C 4H1

Pharmacist Awareness Week

March 7th–13th, 2005

A Healthy Partnership: You and Your Pharmacist

2 COMMUNICATION JANUARY/FEBRUARY 2005

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PHARMACY

Features

Continuing Education

Departments

Cold Sores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Pharmacist Awareness Week . . . . . . . . . . . . . 11

International Pharmaceutical Science Federation World Congress . . . . . . . . . . . . . . . 12

The Last Word … Waiting For Help: Pharmacists Are Being Pushed To Health Care’s Front Lines . . . . . . . 18

Therapeutic Options Focus on Oral Contraceptives

Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Sounding Board . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Q&A: Getting to Know Your Manitoba Pharmacists . . . . . . . . . . . . . . . 15

Classifieds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Vol. 30, No. 3 January/February 2005

COMMUNICATION JANUARY/FEBRUARY 2005 3

Manitoba Society of Pharmacists

Board of DirectorsBrent Havelange, President

Marian Kremers, Past President

Meera Thadani, Vice-President

Nancy Remillard, Secretary Treasurer, Finance Chair, Professional Relations Chair

Jason Pankratz, Economic Committee Chair

Denysia Wincott, Membership Chair

Jay Rich, Communication Journal Chair

Lisa Zaretzky

Laurie Kaminsky

LiaisonsChuck Narvey, Insurance Liaison

Ron Guse, MPhA Liaison

Elmer Kuber, CPhA Liaison

Beatrice Reyes, Student Liaison

Scott Ransome, Executive Director & Editor

Jill Ell, Assistant to the ExecutiveDirector & Editorial Assistant

Editor/Publisher

Manitoba Society of Pharmacists90 Garry Street, Suite 202Winnipeg, MB R3C 4H1

Telephone: (204) 956-66801-800-677-7170

[email protected]

www.msp.mb.ca

COMMUNICATION is published six times a year. The subscription rate is $12.00 per issue, $77.04 per annum (including GST). The inclusion of proprietary names in this publication is for reference only. The inclusion of brand names does not imply that the brands listed are in any way preferable to those not listed. The sources of information are published articles in pharmaceutical and medical journals, private communications, etc. Incorrect quotations or interpretations are possible but not intentional. The views expressed in COMMUNICATION do not necessarily reflect the views of the Manitoba Society of Pharmacists Inc. The Society assumes no responsibility for the statements and opinions advanced by contributors in COMMUNICATION. Material from COMMUNICATION may be copied provided that the source is acknowledged. The deadline for submission of material for inclusion in COMMUNICATION is the 15th of February, April, June, August, October and December.

ISSN 0829-6197

Printed in Canada by:Leech Printing (204) 728-3037

Publication Mail Agreement No. 40013710Return Undeliverable Canadian Addresses to:

Manitoba Society of Pharmacists202–90 Garry Street

Winnipeg, MB R3C 4H1Email: [email protected]

EditorialLet the good times roll…well, at least they

did. Over the past 5 years or so, pharmacists as a whole have experienced an incredible run in terms of earning potential, one that many would say had been long overdue (maybe 20 odd years overdue, depending on who you ask).

According to my rough statistics, pharmacist wages in the community had been holding the fort in the $20 range for much of the 80’s and 90’s. If you wanted a raise in pay, you had to (gasp), negotiate it, which meant actually screwing up the nerve to ask for it. Let’s just say that a cost of living increase was starting to look pretty good.

But then came the supply and demand stage of the late 90’s, and man were we ever in demand. Akin to a witches brew, the perfect combination of ingredients turned our profession on fire, and salaries rose like a thermometer in Phoenix. Statistics show that the maximum salary more than doubled in around 6 years. And don’t forget those benefits. Was that a signing bonus you mentioned? Pay my tuition while you are at it please. Show me another profession that has experienced that kind of growth.

But as they say, all good things must come to an end. If you are a pharmacy student and reading this, you already know exactly what I am talking about. The Big Chains are not exactly lapping at pharmacy students’ feet this year as they have in the recent past. Some of them are not even hiring at all. The same goes for the hospitals. They need some of you, but nothing like years past. And then there is the trickle back from the IPS, as some pharmacists slowly put their foot back in the door, “just in case”. What will it be like for the class of 2006?

Ask any pharmacist that has been around long enough, and they will tell you that these things always go in cycles. “There were no jobs the year I graduated”, many will say, “and then the next year there were plenty”. So as these “good times” grind to a halt, we can always look forward to the next perfect storm, although it is doubtful a roll quite like this one will be experienced again anytime soon. MSP ■

D’ARCY & DEACON LLP enjoys a carefully built reputation as one of the foremost law fi rms in Winnipeg. Our lawyers bring comprehensive experience and proven expertise to the institutions, businesses, organizations and individuals we serve. Respect for the well-being of our clients, while maintaining the fl exibility required to ensure the provision of direct and cost-effective representation and counsel, remain the cornerstones of our practice.

As part of that mandate, D’ARCY & DEACON LLP is proud to provide legal services to Members of the Manitoba Society of Pharmacists (“MSP”). In consultation with the MSP, the Firm has developed a unique Legal Assistance Program to maximize advantages available to Manitoba Pharmacists. Written information regarding D’ARCY & DEACON LLP and the Legal Assistance Program is available to all Members from both the Firm and MSP.

KENNETH A. FILKOW, Q.C.

JAMES G. HARLEY

BRIAN J. MERONEK, Q.C.

B. PATRICK METCALFE

PAUL G. SARANCHUK*

RICHARD M. RICE

MICHAEL D. WERIER

RUSSELL G. WOOKEY

D. MICHAEL WILLCOCK

GWEN B. HATCH

MICHAEL G. FINLAYSON

ROGER D. GRIPP

MICHAEL D. RICHARDS

GRANT A. STEFANSON

JOHN C. STEWART

HAROLD COCHRANE**

HAROLD K. IRVING, Q.C.

JOHN E. DEACON, Q.C.

DAVID MORRY

WALTER THIESSEN

ROBERT J. GRAHAM

JEFFREY L. BROWN

DARCIE C. YALE

DERYK W. COWARD

BRADLEY D. REGEHR

DIANE M. STASIUK***

JONATHAN L.

GOLDENBERG

ERIN L. KEEDIAN

KRIS M. SAXBERG

DANNY D. KREKLEWICH

R. IVAN HOLLOWAY

KENNETH J. MUYS

* Also of the Alberta Bar

** Practising through Harold Cochrane Law Corporation

*** Also of the Ontario Bar

IVAN J.R. DEACON, Q.C. (1900-1974)

NORMAN J. D’ARCY, Q.C. (1889-1980)

GRAEME T. HAIG, MC, CM, CD, Q.C. (1923-1993)

RUDOLPH ANDERSON (1923-2001)

12th FLOOR330 ST. MARY AVENUEWINNIPEG, MANITOBAR3C 4E1

TELEPHONE: (204) 942-2271

FACSIMILE: (204) 943-4242

EMAIL: [email protected]

WEBSITE: www.darcydeacon.com



FEATURE

Retirement and Estate Planning• review current plan• identify concerns and options

Tax Planning• review current income tax planning• identify opportunities and provide

solutions

Life Insurance Brokerage• review current insurance needs• review current insurance policies• term insurance/universal life• joint last-to-die life insurance• mortgage insurance• disability insurance/25% discount

to members• group insurance • segregated funds

/creditor protection

What’s New?Ed Bodnarchuk, your CPBA Advisor, has made availale the following services in addition to the CPBA Programs:

The Sounding Board is here for

members to speak up and speak

out on issues that are of inter-

est to pharmacy. The Sounding

Board is not intended to be an

expression of the opinions of the

Manitoba Society of Pharmacists,

but rather is meant to be a forum

for opinions and thoughts. We

encourage you, our members, to

write in with your opinions on the

topical issues of the day.

CPBA programs include:Group Health & Dental

Group LifeGroup Disability

Optional LifeOptional Disability

CPBA, your insurance broker is dedicated to your needs.

Ed Bodnarchuk210-530 Kenaston Blvd.Winnipeg, Mb, R3N 1Z4Ph. 204-988-1517Fax 204-988-1518Email [email protected]

December 2, 2004

Manitoba Pharmaceutical Association Newsletter

187 St Mary's Rd

Winnipeg, MBR3C 0S6

Dear Collegue,

The many great successes the Canadian Diabetes Association has had over the years have depended

on individuals making an extraordinary effort by devoting tremendous time, energy and thought to

the cause of helping, directly or indirectly, people with diabetes.

One such individual is Ms. Morna Cook. On behalf of the Association, we would like to thank you

sincerely for your support of Morna Cook. In October, Ms. Cook was awarded the BD Volunteer

Service Award at the CDA/CSEM Professional Conference in Quebec City. This award is to

support the professional development of health professionals in their specialty practice.

Generous and dedicated support from an employer is invaluable to persons who wish “to go the

extra mile” in pursuit of excellence. These efforts assist our Association in helping people affected

by diabetes attain an optimal quality of life.

On behalf of the Canadian Diabetes Association, thank you again for the generous support you have

provided to Ms. Morna Cook.

Sincerely,

Dr. David HillChair, Board of Directors

Michael C. Howlett

President & CEO

Scott Ransome, Editor

Communication Magazine

202-90 Garry St.

Winnipeg, MB R3C 4H1

Dear Mr. Ransome,

Sounding Board


FEATURE

WHAT IS A COLD SORE?

Herpes simplex labialis, also called “fever

blisters” and “cold sores” are vesicular

lesions that typically occur in or around

the mouth. They initially cause pain, burning, or

itching before

bursting and

crusting over

They are caused

by the herpes

simplex virus

type 1 (HSV-1)

which remains

dormant in the

body and may be

reactivated by a

variety of

factors (for

example,

stress, fever

or sunburn)

Figure 1

shows an

electron

micrograph of HSV-1. Genital herpes is caused by

herpes simplex virus -2.1

Figure 2 shows a cold sore involving the

mucocutaneous junction of the upper lip. This

lesion is early in

its development.

There is tissue

swelling

(edema)

and vesicle

formation.

Figure 3 shows

a cold sore

involving the mucocutaneous junction at the

nostrils. The ulcerated areas have crusted over

(arrows). This lesion is later in its natural history.

EPIDEMIOLOGY

Herpes simplex virus 1 (HSV-1) primarily

causes herpes labialis, a recurrent infection

characterized by cold sores. HSV-1 is spread by

personal contact, because the virus is shed in

saliva, tears, genital and other secretions.

Most people are infected at a young

age, shown by high seropositivity in young

populations. About 20 to 40% in the general

population are affected. The virus is transmitted

by close personal contact with a person with

HSV-1. A common form of transmission results

from a kiss given to a child or adult from a person

shedding the virus.2

The primary infection of HSV-1 often goes

Cold SoresPrepared by M. B. THADANI, B.Sc.(Pharm.), M.Sc.

Figure 1

Figure 3

Figure 2


Cold Sores

unnoticed by the patient. Symptoms experienced

may include a mild fever and lesions on or around

the mouth after a 2-12 day incubation period.

Primary infection can also occur in the:

• eye to cause conjunctivitis and keratitis,

• fingers to cause herpetic whitlow, a painful

infection of the periungual (situated or

occurring around a fingernail) region of the

finger. A damaged cuticle is thought to be

the point of entry. In children the source of

infection is the oropharynx. In adults it is

usually a genital HSV-2 infection.

• genital (potentially through oral-genital

contact) region.

Events that precipitate cold sore formation

can be identified in some patients. These may

include:

• Emotional stress.

• Illness (for example, a cold).

• Menstruation.

• Physical trauma.

• Strong sunlight (ultraviolet light).

The lesions tend to recur at the same sites,

usually at the mucocutaneous junction (Figures 2

and 3).

• These mostly involve the lips, when cold

sores are also known as herpes labialis.

• Less commonly, the nostrils are involved.

Each cold sore follows a typical natural

history:

• Some patients can have a brief prodromal

phase of burning or tingling at the site

where the cold sore will develop.

• Vesicles form at the mucocutaneous

junction and quickly burst leaving ragged,

weeping ulceration. This fluid is infectious.

There is inflammation and edema present.

• Each lesion crusts over and heals without

a scar over a 7-10 day period. Lesions are

infectious until the crusting is complete.

In immuno-competent patients cold sores are

self-limiting and are not associated with systemic

symptoms. However, they are unattractive and

uncomfortable.

Avoidance of known precipitating events is

useful for some patients. For example, avoidance

of strong sunlight and the use of sunscreen can

help reduce the number of episodes.

TREATMENT OF COLD SORES

Non-prescription treatment of cold sores is

symptomatic and Canadian products3 contain

ingredients that are:

• local anesthetics (benzocaine, lidocaine,

tetracaine hydrochloride)

• external analgesics (camphor, phenol and

menthol),

650-1000 mg q4-6h

650-1000 mg q4-6h

200-400 mg q4-6h

1-2 t q4h prn (8-16mg codeine)

Usual Dose

Cyp450 1A2

Gut and plasma

hepatic

hepatic

Metabolism

Acetaminophen

ASA

Ibuprofen

Drug

Exempted Codeineproducts

4000 mg/24 h

4000 mg/24 h

1200 mg/24 h

Maximum dose/24h

Not to exceed 12tabs/24 h


Problems – or more appropriately – personal problems. We all experience them, and work them out most of the time. Some problems might involve

• Marital issues• Financial issues• Family issues• Chemical use (including alcohol)• Emotional/psychological/physical issues• Gambling

Because we are all unique as individuals, we respond differently to problem situations. At times, however, these problems may seem next to impossible to resolve on our own. We may need HELP! The Pharmacists-At-Risk committee is dedicated to the care and assistance of pharmacists in need of Physical, Psychological, Social and Spiritual Support. If you or a colleague are experiencing personal problems, no matter what the issue may be, the Pharmacists-At-Risk Committee can HELP. All calls and inquiries are CONFIDENTIAL.To access the At-Risk Program please call 992-2704 and leave a message. Your call will be returned within 24 hours.

ManitobaPharmacist-At-RiskProgram

“let us help … you … keep it together”

ManitobaPharmacist-At-RiskProgram

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Our professional consultant will cover all aspects of your vehicle acquisition.

LEASE PURCHASE NEW USED

SELECTION TEST DRIVE PRICE DELIVERY

To take full advantage of our MSP AutoLease/Purchase program, contact our plan manager,

Paul Wilkes at 941-1973,or the MSP office at 956-6680.

NVSNVSNational Vehicle Services

• astringents (tannic acid, zinc chloride),

• protectants (petrolatum) to prevent

excessive drying of the lesion,

• sunscreens

• systemic pain relievers (acetaminophen,

ibuprofen, aspirin, exempted codeine

products). The doses for non-prescription

analgesic products are given below.

Bacterial anti-infective agents (polymyxin B,

cetylpyridinium chloride) are not anti-viral agents

and their use is not recommended. Should there

be a bacterial infection complicating the lesion,

the patient should be referred to a physician for

diagnosis.

While available in Canada in a non-

prescription product, there is no published data on

the safety and effectiveness of heparin.4

Topical 5% acyclovir cream, ointment and

oral tablets are available by prescription only.5

Topical acyclovir can induce viral resistance.

There are concerns that inappropriate use of

topical acyclovir may limit the effectiveness of

systemic acyclovir in the treatment of serious HSV

infections. Recurring infections that may benefit

from systemic therapy with acyclovir or other

anti-viral agents should be referred to a dentist for

physician for evaluation.

HN

N

N

N OOH

O

H2N

Acyclovir

Complications of primary infection include:

herpetic infection of eczematous skin areas

leading to severe disease in young children, acute

necrotizing encephalitis, and neonatal infection

acquired from the genital tract of the mother.

Cold Sores


Cold Sores

Primary lesions clear up in two to three

weeks and the virus is transported to the dorsal

root (trigeminal) ganglion, where it remains

latent. The latent virus stays there for life and can

cause recurrent infections characterized by cold

sores. Reactivation can begin with a prodrome

of pain, burning, or itching where a lesion may

appear. The lesions generally occur around the

junctions of the nose and the skin or the mouth

and skin. In about a week, these lesions scab over

and the virus returns to latency. The recurrent

infections are triggered by a number of factors

including: other viral infections, direct sunlight,

stress, menstruation, and immuno-compromise.

In addition, in immuno-compromised hosts,

reactivation is more severe and has more

potentially harmful complications.6

Prevention requires

• Using sunscreens

• Reducing stress

• Avoiding spread to other parts of the body

and to others by frequent hand-washing

until the lesion has healed.

REFERENCES:

1. http://www.dentistry.leeds.ac.uk; accessed 26 November 2004

2. Hwang, Y.S., Lpruance, S.,L., Epidemiology of Uncommon HSV-1 Infections, Herpes 6:1 1999, 16-19.

3. Repchinsky, C., Compendium of Self-Care Products, Canadian Pharmacists Association, Ottawa, 2002-2003.

4. Repchinsky, C., Patient Self-Care, Canadian Pharmacists Association, Ottawa, 2002.

5. Budavari, S., The Merck Index, 13th edition, Merck & Co., NJ, 2001.

6. Merck Manual on line, accessed 26 November 2004.

This is part of a series of articles on non-prescription therapeutics prepared for Laboratory 46.210. ■

THE FORT GARRYTHE FORT GARRYTHE FORT GARRY

call 204-942-8251 • 1-800-665-8088 w w w . f o r t g a r r y h o t e l . c o mcall 204-942-8251 • 1-800-665-8088 w w w . f o r t g a r r y h o t e l . c o mcall 204-942-8251 • 1-800-665-8088 w w w . f o r t g a r r y h o t e l . c o m

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Manitoba PharmacyConference

Victoria Inn, Winnipeg

10 COMMUNICATION JANUARY/FEBRUARY 200510 COMMUNICATION JANUARY/FEBRUARY 2005

Position Statement

Removal of Tobacco Products From Manitoba Pharmacies

Manitoba’s pharmacists are performing an increasingly important role in the health care

of Manitobans. As the most accessible and well-trusted frontline health professionals,

pharmacists promote health awareness, prevention and treatment of diseases through

appropriate drug therapy and non-drug decisions;

Manitoba’s pharmacists and the Manitoba Society of Pharmacists have assumed professional

responsibility in tobacco reduction initiatives and smoking cessation programs in the overall

goal of wellness promotion and recognize that selling tobacco puts these pharmacists in a

confl ict;

Five provinces have already prohibited tobacco sales in pharmacies and in establishments

containing pharmacies (Newfoundland, Nova Scotia, New Brunswick, Quebec, and Ontario)

and stakeholders including physicians, MANTRA, MPhA, dentists, and the public are

supportive of removing tobacco from pharmacies;

A recent survey of members of the Manitoba Society of Pharmacists found that 84% of

respondents do not support tobacco products being sold in pharmacies, and 86% of

respondents believe that the Manitoba Society of Pharmacists should adopt a formal position

with respect to the sale of tobacco products in pharmacies;

The Board of Directors of the Manitoba Society of Pharmacists takes the position that

comprehensive tobacco reduction legislation be adopted that does not allow the sale of

tobacco products within premises with a pharmacy; that the legislation must apply to all

businesses that operate a pharmacy; and that, upon proclamation, a 12-month transition

period be provided prior to implementation of the legislation.

Adopted: Dec. 8, 2004 Board of Directors Manitoba Society of Pharmacists


FEATURE

During this year’s Pharmacist Awareness Week (PAW), March 7-13, the Professional Relations Committee of the Manitoba

Society of Pharmacists (MSP) is taking action to promote the gains pharmacists have made in recent years. We will continue to work hard to ensure Manitobans understand the need for an expanded pharmacist role in primary health care.

This year’s message is, “A Healthy Partnership: You and Your Pharmacist”. The message, aimed at patients, clients, politicians and the media underlines a fundamental truth in health care - that proper medical treatment requires effective medicines AND effective patient care. Pharmacists, with years of specific training in medications and their effect, are ideally placed to offer such care, and are already doing so. PAW is an important vehicle to raise Manitobans’ knowledge and appreciation of pharmacists’ contribution to their overall health, and how much more could be done in partnership.

Your MSP Professional Relations Committee will reinforce these messages through media releases, advertising and guest appearances on programs such as A-Channel’s Big Breakfast.

Last year’s successful Medicine Cabinet Clean-Up campaign will once again be promoted. Pharmacies across Manitoba will be provided with bags for medication returns. Patients will take home their ‘clean-up’ bag and fill it with their unused medication. The bag will be printed with messaging, not only about the Medicine Cabinet Clean-Up campaign, but with information about the partnership between ‘Patients and Pharmacists’. Please encourage your patients

to take part in the campaign by returning their expired and unused medications.

We will also be re-issuing the Romanow-based poster and bookmark to display at your pharmacy. To request your Medicine Cabinet Clean-Up bag supply and additional posters, please email [email protected] or call the MSP office at 986-6680.

Be sure to check the MSP website, www.msp.mb.ca, for more specific information, timelines and guides for what you can do to get involved in PAW. As always, we encourage you to let us know (via email) what your pharmacy is doing for PAW. (Your entry must be received by April 1, 2005 to qualify for this year’s PAW Grand Prize Draw). Simply email us a picture and a brief description of your event!

If you have any questions, or for more information, check out the MSP website or drop us an email at [email protected].

And remember, spring is just around the corner, so start planing your PAW event today!! ■

Pharmacist Awareness Week“A Healthy Partnership:

You and Your Pharmacist”


FEATURE

The 50th Annual International Pharmaceutical Science

Federation World Congress was held in Halifax, Nova Scotia. For 10 days, Canada was home for more than 300 Pharmacy Students from 40 different countries.

At the beginning of the conference, I have to admit that I was quite overwhelmed by the number of pharmacy colleagues from around the world. (Over 30% of the delegates were from Taiwan). However, even though I may not be able to speak French, Spanish, or Mandarin, I found that it was our common interest of promoting pharmacy that enabled us all to become close friends immediately.

Along with Nicole Clement and Orla Nazarko (fellow U of M pharmacy students), we were able to gain valuable knowledge of pharmacy practice abroad. From our newly found friends of Portugal, we discovered that nearly every medication (including Acetaminophen

and Ibuprofen) requires a prescription from a physician. On the other hand, our Egyptian colleagues enlightened us that nearly all their medications did not require a prescription in order to be dispensed. Yet, despite these differences, I believe that the role of a pharmacist is highly respected around the world.

Throughout the congress, there were many interesting seminars available for delegates to attend. The one I found the most interesting was “Design your own pharmacy.” We were able to work in a group setting where delegates from various countries contributed their innovative ideas. As I conversed with my fellow colleagues, I realized that there are various countries in the world that are light-years ahead of us in providing pharmaceutical care. For an example in Singapore, the majority of the community pharmacies have multi-disciplinary teams consisting of physiotherapists, dieticians,

and nurses readily available to consult with their patients. I believe that pharmacies in Canada should follow in their footsteps in order to provide optimal care for our patients.

Scientific symposiums were also held at the conference and one dealt with the role of the pharmacist in the recent Walkerton water contamination incident. Ms. Roseanne Curie and Ms. Adele Kaminski, two pharmacists working in Walkerton, Ontario, shared with all their experiences in dealing with this problem. Everyone was captivated by the fact that pharmacists were the first to take notice of the possible problem that occurred in Walkerton because of the increase in sales of anti-diarrhea medications. Pharmacists also played a major role in educating the committee. As front line medical professionals, pharmacist counseled patients in ways to prevent contamination.

Besides educational sessions, there were many

International Pharmaceutical Science Federation World Congress

Halifax, Nova ScotiaJuly 25th – Aug 3rd, 2004


The Manitoba Society of Pharmacists Holiday Reception was held at the Fort Garry Hotel on the evening of Dec. 8th, 2004. The evening was well attended and appearances were made by The Honorable Tim Sale, Minister of Health; Myrna Dreidger, Health Critic, and Stuart Murray, Official Leader of the Opposition.

Pictured: MSP’s Executive Director, Scott Ransome; Board Member and Economics Chair, Jason Pankratz; Honorary Life Member, Archie Orlikow and a few of the invited guests.



social activities as well. There was no better way to welcome our guests to Canada than to visit the historical museum of Pier 21. Ever since the 1920’s, Pier 21 served as “Canada’s front door” for over a million

immigrants, refugees, and troops. All the delegates were able to enjoy the night that was filled with Canadian heritage. All the delegates were also able to enjoy the great Canadian outdoors. The

reception committee organized tours to Peggy’s Cove and also to Hatfield’s Farm. Many, including myself, took delight in riding the mechanical bull that the farm had to offer.

I would like to express my sincere thanks to the Manitoba Society of Pharmacists for all their generous support. The experience I have gained from this conference was priceless. The friends that I have made will last for a lifetime. Ultimately, I have realized that pharmacy as a profession is being very well represented throughout the world.

Vive la pharmacie!

Carey Lai

CAPSI National PresidentUniversity of ManitobaClass of 2005 ■

Team Canada at IPSF World Congress 2004

MSP Holiday Reception


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Are you looking to work in a patient focused care setting?

Do you want to work for a company which provides a strong team environment?

Are you looking for a company that can provide you room to expand your skills and future opportunities?

Do you want to feel secure and work for a company that will provide you an outstanding benefits package as well as bonus potential for your skills?

Our Benefits Package allows you to earn over $100 000 in compensation and benefits.

Our Bonus Plan allows you to receive potential yearly Bonuses as a Staff Pharmacist.

Our Prescription Sharing Plan allows you to enjoy potential yearly Profits as a Staff Pharmacist.

In addition, we believe in reimbursement for cognitive services and as such have developed positions in many practicing specialties including:

• Long Term Care Clinical Pharmacists• Asthma Certified Pharmacists• Certified Diabetes Educating Pharmacists• Men’s and Women’s Health Specialty Pharmacists

If you are a pharmacist who is licensed to practice in the province of Manitoba, and looking to provide patient focused care within a strong team environment, then this opportunity may be for you.

Together, the Safeway family is one of the largest employers of retail pharmacists in North America, and in Canada operates pharmacies in British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario.

We currently have full time employment opportunities for both staff and manager positions in various rural Manitoba locations.

If this is an opportunity of interest to you, please send a cover letter and resume by e-mail or fax to the address below. New grads are welcome to apply.

Farzin Rawji, B.Sc. PharmPharmacy Recruiting CoordinatorCanada Safeway Ltd.14360 Yellowhead Trail, Edmonton, AB T5L 3C5Voice Pager: (800) 749-4974 Fax: (780) 439-4227Email: [email protected]

Q&A: GETTING TO KNOW YOURMANITOBA PHARMACISTS

HOURS OF OPERATIONMonday - Friday 9 am - 8 pm • Saturday 9 am - 4 pm • Sunday 11 am - 4 pm

Validated Parking at TD Centre Parkade - Monday - Friday 9 am - 5 pm

• Manicure and Pedicures

• Colours and Styles

• Massage Therapy

• Tattoos and Piercing

• Esthetics

• Reflexology

• Chemical Relaxing & Straightening

• Hair Extensions

• Nail Art

All MSP card holders* will receive 20% off all services and products

available at Vault Salon & Spa.

FREE consultation with one of our highly talented stylists.

*Card must be presented to receive the discount.

Vault Salon & Spa will be expanding into a

full service day spa.

100 - 52 Albert StreetPhone: 957-1100 • Fax: 953-2143

15085 Vault Mag Ad 4/26/04 3:24 PM Page 1

Do you know someone who is making a difference in the pharmacy community? We would like to highlight them in this article!

Please contact the MSP office at (204) 956-6681 or [email protected].

Name: Nancy RemillardPlace/Year of Graduation: University of Manitoba, Faculty of Pharmacy, 1996. We were the first graduating class from the new 5 year program.Years in Practice: 8Currently Working: I am currently on Maternity leave and I will be returning to work at PharmaPlus Drugmart on Lakewood Blvd in December.Accomplishments in pharmacy: Participated in the Manitoba Pharmaceutical Care Project, wrote a Manual on “Standards of Practice on Pharmaceutical Care: A Self-Assessment Guide” (under review), Certified Asthma Educator 1998, Bonnie Schultz Award 1999, Board of Directors of MSP 2001-present, Professional Relations Committee Chair, Pharmaceutical Care Committee Chair, Honorary Secretary Treasurer of MSP.Family: My husband, Loren, is a Communications officer with the Department of Indian and Northern Affairs. I have two sons, Ethan, 3 years old and Kyle 1 year old. Hobbies: I love to read novels, scrapbook, curl in the winter and walk in the summer.Community activities: I’m sorry to admit but I don’t have any... too busy with family, work and MSP.Favorite thing about Manitoba: Summers at Grand Beach.Most relaxing vacation choice: If we could, vacation anywhere in the Caribbean but I’ll settle for a cabin on Lake Winnipeg.Pet peeves: Small bits of popcorn in your bucket at the movie theatre.Favorite fictional character and why: I guess it would have to be Austin Powers because he’s just so funny, he’s a multi-tasker (Dr.Evil/Fat Bastard) and you can always make fun of him.What could you do without forever: I would have to say mosquitoes.What couldn’t you do without for even a day: Coffee and of course my three boys.What you love about pharmacy: I love talking with patients and making a difference in their lives both from a personal and health perspective. ■



Pharmacy is the most important part of our business at Shoppers Drug Mart® / Pharmaprix®, and we want you to be a part of it. As Canada’s leading pharmacy, we have tremendous career opportunities. We offer competitive salaries and benefits and, if you have an entrepreneurial spirit, the chance to become a Pharmacist Owner. You will also have access to rewarding professional practice opportunities, career development and leading-edge technology. Achieve your full potential while providing top patient care.

We are currently looking for Licensed Pharmacists for: • Winnipeg, MB • Brandon, MB • Morden, MB • Thunder Bay, ON

For the experience of a lifetime, please contact in strict confidence:

Samantha Beaudry, Recruitment CoordinatorPhone: (306) 586-8582 [email protected] Or visit our website. www.shoppersdrugmart.ca

PHARMACIST OPPORTUNITY: Looking for a change? Generous salary, no evenings, no Sundays or holidays, friendly staff. Call Keith at (204) 367-2517; evenings(204) 367-8635, fax (204) 367-2984.

FULL TIME PHARMACIST REQUIRED for Rock Lake Pharmacy, Crystal City, MB. No evenings or holidays, closed for lunch. Close to a wide range of recreational activities. Housing available for successful applicant. Competitive salary offered with the opportunity for partnership into business if desired. For more information contact: Wayne Currah at work (204) 867-2071 or home (204) 867-3978.

FULL TIME PHARMACISTS WANTED: Super Thrifty requires full time pharmacists at the following Manitoba Locations: Virden and The Pas. Career opportunity for experienced pharmacist or new grads. Good communication and human relations skills are an asset. Quality rural lifestyle, no evenings, Sundays, or holidays, technician Support, salary negotiable, profit sharing available, health benefit package, future ownership opportunity. Contact Tom Busch at: Phone (204) 727-8451, fax (204) 727-3471 or [email protected] All replies kept confidential.

FULL-TIME PHARMACIST needed for busy but well-organized community pharmacy in Northern Manitoba. We’re looking for someone who works well as part of a team and genuinely cares about people. Call Mike (204) 778-8391 Shoppers Drug Mart, Thompson, MB

PHARMACIST WANTED: Full/Part-time with flexible hours at a newly opened pharmacy in the north end of Winnipeg. No weekends and no evenings. Please forward resume to [email protected] or by Fax 204-339-8023.

PHARMACY WANTED in Winnipeg or surrounding areas. High prescription volume. Please call (204) 388-4533.

LOOKING TO BUY a pharmacy in the Winnipeg area. Please call 1-204-685-3069.

PHARMACIST WANTED: Pharmacy has immediate opening for licensed pharmacist. We require excellent pharmaceutical care and communication skills. We offer competitive rates and a very flexible schedule, unique arrangement. For more information contact Tony at (204) 582-3287.

FULL OR PART TIME PHARMACIST REQUIRED for rural pharmacy in Morden/Winkler area. Monday to Friday, no evenings or weekends. Wage $65.00 per hour or profit sharing opportunity. Call Steve at (204) 242-2446.

Advertisement rates range from 1/6 page black & white to full page, full colour. Save more with multiple issue ad placement. Classified personal (individual) ads are free

to any MSP member. Contact MSP for classified rates for non-MSP members and business (corporate) classified

ads (priced according to size).

All rates are subject to GST. Space is limited.Call MSP today at (204) 956-6680 for the full current

2005 ad rate schedule.

CLASSIFIEDS

SOUTHERN SASK. PHARMACY FOR SALE• Two Doctors/50 nursing home beds

• 27,000 RXs for last year—increasing

• Large, 85 staff employer in town

Contact: Ron Zimmer: 306-869-3183

Email: [email protected]

®

FULL TIME PHARMACIST POSITIONAre you looking to work in an environment where customer service is a focus, the support staff is excellent, and are involved in the community? If this sounds like the type of place you would like to work, please read on…

Position Details: Starting Salary range: $90,000 – $100,000

depending on experience Three Weeks paid vacation Will pay all licenses and Medical Insurance costs Work between 35 – 50 hours per week Store is closed on Sundays and Holidays Great Benefi ts Package

If you are interested in this position, please forward your resume to:

Paul Melnyk, Pharmacy Innovation ManagerPharmasave Drugs (Central) Ltd.206-584 Pembina HighwayWinnipeg, MB R3M 3X7Fax: 204-985-0525Email: [email protected]


Retired? or Bored?Pharmacist required Saturdays Only!

10am til 5pm Will pay for yearly license fee plus

competitive hourly rate of pay!All you do is work Saturday and relieve my Pharmacists Vacation

Call Jim @ 837-7882 Ext # 7

LOOKING FOR A PHARMACIST TO RELOCATE TO THE TOWN OF ROBLIN,

MANITOBA.

A town considered to be the jewel of the Parkland.

Roblin is located on the Manitoba-Saskatchewan border

and brags about the great fishing at Lake of the Prairie;

water skiing; golfing and other amenities for a good life.

Pharmasave has a staff of 12 young personable

employees who work hard and play hard.

Competitive salary with a signing bonus

and moving allowance. For more information, please

call 1-204-937-6505 and ask for Darren or Vera.

CLASSIFIEDS

[email protected]

© HR AD•WORKS™

**Who Where Wow - the 3 W’s in www.mbjobs.ca - HR Pros will love it!Manitoba’s newest online site - Screen & Track your Applicants,

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Client: NWCDocket: 412-059Section: CareersInsertion Date(s): December 10/04Ad Size: 7.25” x 3”

• • • • • • • • • • Insertion Estimate (excluding GST) • • • • • • • • • •Media:Manitoba Society of Pharmacists $

$ $ $ $

one cool place to work. Retail Pharmacists Wanted,Inuvik, NWT or Iqaluit, Nunavut.Total Compensation $110,000 per year including:

Bonuses, Medical & Dental,Subsidized Food & Fully Furnished Housing,

Employee Ownership, Paid Trip.

Bank $65,000 after tax, food & housing expenses.

For more info & to apply, please visit our website at

www.northwest.ca

The Medication Information Line for the Elderly

(MILE)

has relocated to the

University CentrePharmacy

University of Manitoba

Please visit us at

Room 111 University Centre

(204) 474-6493

9:30am to 2:30pmMonday to Thursday

email: [email protected]

PHARMACIST OPPORTUNITYFOR A PRIME LOCATION IN

STEINBACH, MB

Call Wes or Bob 1-888-411-9311Prudential Riverbend Realty

Looking for Locums in Winnipeg.Please contact Manny Morry at 896-4577.


Waiting For Help:Pharmacists Are Being Pushed To Health Care’s Front Lines

By ANDREW ALLENTUCK

THE LAST WORD …

In the intervals between referral to a specialist and subsequent treatment,

pharmacists may become therapists by default. Whether a patient seeks relief of pain or amelioration of a condition that will subsequently be treated by a physician, the pharmacist becomes the front line health care worker, able to refer but seldom able to treat.

Data from the Fraser Institute, a Vancouver-based public policy research organization, provides a means for estimating the intervention of the pharmacist in the gap between prospective diagnosis by a general practitioner and the specialist’s chosen treatment.

The median wait between referral by a general practitioner and treatment in Manitoba is 14.8 weeks in 2004, compared to 15.1 weeks in 1993. That is an improvement over the 15.1 weeks wait in 2003 and the 17.8 weeks wait in 2002.

How long patients must wait for treatment depends on what ails them. Waits are briefest for medical oncology, an average of less than one week for urgent cardiovascular surgery, and longest at 24 weeks

for elective cardiovascular surgery.

An aging population has a higher than average need for medical care. The median age of Canadians is rising. In 2001, it was 37.6 years, an all-time high, compared to 25.4 years at the end of the baby boom in 1966, according to Statistics Canada. Manitoba, it would appear, has the highest level of health care spending of any province. According to the Canadian Institute for Health Information, spending on health care goods and services in 2002 was $2,965 per person in Manitoba compared to the $2,526 Canadian average.

The fastest growing component of the population of Canada is those 80 and over. This category soared 41% to 932,000 in 2001 compared with 1991. Statistics Canada projects that the cohort of 80 and over persons in Canada will rise an additional 43% by 2011 when it will be in excess of 1.3 million.

The cohort of Canadians aged 45 to 64 also rose, though not so dramatically as those 80 and over. Between 1991 and 2001, membership in the 45 to 64 group increased 36%. The

result is that the working-age population has become strongly dominated by older persons.

Canada’s declining birth rate is reducing those able to generate incomes the taxes on which help to fund medical and hospital services. Statistics Canada data show that there were 1.7 million children in the group of aged four and under, down 11.0% from 1991. By 2011, the cohort may decline to 1.6 million, says Statistics Canada.

Demographic trends have a powerful effect on demands for health care services. Data from the College of Physicians and Surgeons of Manitoba show that the number of licensed medical practitioners in Manitoba increased between July, 1999 and April, 2004 by 6.8% to 2,176. That is a growth rate of 1.4% per year. If the trend of licensure does not change, the demand for most medical specialties will far outstrip the supply except, perhaps in pediatrics.

How will the time lapse between demand for health care services and physicians able to supply it be closed? It is useful to make a distinction between services that are institutionally


The Last Word … Waiting For Help: Pharmacists Are Being Pushed To Health Care’s Front Lines

paid, such as hospital beds and high technology medical services, and those that may be funded in some part by payments from patients’ own pockets.

Consider coronary heart disease. Fraser Institute data indicate that mortality due to coronary heart disease declined by 43% between 1980 and 1990. Some of the decline was due to high tech intervention, including surgery, and part was due to low-tech intervention, such as increased exercise and changes in diet following consultation.

Canada has been slow to invest in medical technology compared to other countries in the Organization for Economic Cooperation and Development, the OECD. Canada has fewer lithotripter machines for treating such things as kidney stones, fewer MRI and CT scanners and few hemodialysis machines than the OECD average. Using OECD averages of machines per capita, Canada ranks 18 out of 23 OECD countries for MRI machines, 17th for CT scanners, and 13th for lithotripter machines. Scandinavian countries, Japan, Germany, and Switzerland beat Canada in all categories.

What will close the gap between availability of technologies and medical treatments for Canada’s aging population? It is an arguable proposition that it will be drugs. Drug expenditures are

climbing at double digit rates. Inflation accounts for about 3% of the increase, leaving the remainder of drug expenditures to increased demand for them.

In an intriguing study of the relationship between drug consumption and hospital stays, Frank R. Lichtenberg, Professor of Business at the Columbia University Graduate School of Business, found that people consuming newer drugs had fewer hospital stays than people consuming older drugs. The use of newer drugs tends to reduce all types of non-drug medical expenditures, such as physician visits, said Professor Lichtenberg in a Fraser Institute study published in February, 2003. There is a methodological quirk in the study, for it is possible that doctors who know of or who use the newest drugs are more in touch with advancing medical practice than other doctors who prescribe older medicines. Assuming that this covariance is not predictive, then it becomes clear that new drugs are an efficient means for

reducing demand for non-drug medical services.

Drug spending rises with sickness and Canada’s aging population will have more incidents of treatable illness. More drugs will be used if only because other therapies have long waiting lists. Drugs will also be used because they are often a cost-effective substitute for other treatments.

The varieties of drug therapies are due to grow, yet it may be more difficult to have them dispensed. The number of pharmacists in Manitoba who will participate in drug management is increasing more slowly than the population cohort of the elderly is growing. According to the Manitoba Pharmaceutical Association, there were 1,084 practicing pharmacists in Manitoba in 2004 compared to 1,005 in 1999. The increase, 1.6% per year, is far less than the 6.1% predicted average growth of the very old in the next 7 years.

The public policy implications of the doctor shortage bear heavily on pharmaceutical practice in the next decade. There will older, often ill Canadians and there will be fewer physicians for the affected groups. Drug substitution for other treatments will grow of necessity. Pharmacists, who as a group are increasing their numbers more slowly than their patients, can expect to be busy. ■

“What will close the

gap between availability

of technologies and

medical treatments

for Canada’s aging

population?”

Leech Printing, Brandon 124692

You come first. We’re not kidding. You come first. We’re not kidding. From your name on the storefront to full-service programs to responsive daily support,

Procurity Pharmacy Services Inc. and its banner programs are built around you. You hold the greatest value when it comes to your customers, your business, and ours.

Our banner philosophies and marketing strategies are built entirely around your promise to your customers and your inherent value in their community.

Introducing: CounterWise Drug Mart • We Share Great ValuesPromoting your wisdom, knowledge and excellent value, variety and quality of products you provide for customer convenience and peace of mind.

CounterCare Pharmacy • Prepared to Make the DifferencePromoting your strong focus on health, well-being, and your proactive approach: one that includes resources, products, advice and support to make your customers’ visits more informative and helpful.

YOUR CUSTOMERS COUNT ON YOU MOST

For all business supports and strategies required to establish and grow your practice. Leading-edge technology, a seamless distribution network, full advertising and merchandising. All with one-to-one, personal service at every turn.

Profits and EquityYou own your own business, and part of ours. Procurity Pharmacy Services Inc. is 100% owned and operated by member pharmacists and shares all profits and equity. We are accountable to you - that means no disappointments.

YOU CAN COUNT ON US YOUR BUSINESS. YOUR FUTURE. YOUR CALL. Randy Gray, Director of Sales

(204) [email protected]

FORMERLY

Please visit: www.procurity.ca

Documents

Pharmacist Awareness Week - Pharmacists Manitoba · Ask any pharmacist that has been around long enough, and they will tell you that these things always go in cycles. “There were