Community Pharmacist Integration into

the PIHC Renal CKD Patient Clinic • In 2011, Greg Wheeler, from Skaha Pharmacy (the British

Columbia Provincial Renal Agency contract pharmacy in

Penticton), proposed enhancing services to patients of the

Penticton Integrated Health Centre (PIHC) chronic kidney

disease (CKD) clinic, by performing medication reviews at

the clinic.

Payment Options

These services could be provided as part of the BC

Medication Review Clinical Service, which allows a

community pharmacy to be compensated by BC

PharmaCare for performance of a medication review and/or

a follow-up review by a Pharmacist.

Initial Renal Team Meeting

• The IH Renal Penticton-based leadership team fully

supported the idea of using this opportunity (and the

external funding source) to provide medication reviews by

the contract pharmacy at the PIHC

Project Purpose

• To improve the quality of chronic kidney disease (CKD)

care at the Penticton Integrated Health Centre (PIHC)

through the integration of BCPRA-contracted pharmacy

services with the multidisciplinary services currently in

place.

How to Improve Patient Care

• Participation as a dedicated member of the patient’s

health care team

• Higher level of communication between healthcare team

members that improves efficiencies, effectiveness and

patient care

• Access to patient diagnosis and lab values to be able to

effectively evaluate ALL medications and provide other

healthcare team members with appropriate medication

recommendations.

• Bring a different set of skills to the team that is unique to

community pharmacy that can compliment the expertise

of the hospital pharmacists not duplicate it!

The Clinic

• The CKD clinic regularly runs 1-2 days per week at the

PIHC and 12 to 14 patients are scheduled to see a

number of health care practitioners from the

interdisciplinary team, which include:

3 rotating nephrologists; 2 registered nurses;

2 rotating pharmacists; 1 dietitian; 1 clerk; and,

1 manager

• Pharmacist met with the patient for an average of 13

minutes after the nurse and before the nephrologist

• to perform an interview, a medication history, identify any

discrepancies and drug related problems, provide patient

medication education and communicate findings to the team.

Pharmacist Process

Pharmacist Process

Pharmacist Process

After Clinic ( 10 minutes – per patient)

• Billing

• Documentation

• Filing

Quantitative Data Results

• The 3-month project formally conducted from November

9, 2011 to February 8, 2012

Drug Related Problems

• Total of 228 DRPs identified

Patient Experience

• To evaluate the impact the project had on the patient,

telephone surveys were administered

• Overall, patients reported a positive experience when

seeing the pharmacist at their last clinic visit (83%; 15/18).

Several of these patients appreciated having the

pharmacist go through their medications and explain

them; a few others liked having the opportunity to ask

questions about their medications.

Multidisciplinary Team Experience

All team members (10/10) reported they felt the pilot project

was improving patient care.

Interdisciplinary team member experience with the pilot

project was investigated using one-on-one interviews. A

number of key themes emerged from several open- ended

questions related to team member experience with patient

care and professional impact.

Communication Improvement

Team members also reported improved communication

between clinic and pharmacy; that is, less inquires for

clarification about prescription changes and medications in

general from other community pharmacies to the clinic.

Resulting in improved time-management for team members

and pharmacy staffs.

Process Map

BC Kidney Days Award

Health Employers Association of British

Columbia (HEABC) 2013 Collaboration

Award of Merit

Contact Information

• Greg Wheeler

gregwheeler@shaw.ca

Skaha Pharmacy-(250)493-8155

Cell Phone (250) 486-5852

• Other community pharmacists involved in project:

Meghan Highley- Skaha Pharmacy

Travis Petrisor- Skaha Pharmacy

What has happened since?

• IH Renal Program has continued to utilize this model

• Ongoing in Penticton

• Expanded to:

• Kamloops

• Trail

• Cranbrook

• Preparing to trial the model in post-transplant renal clinic

Pros and Cons

• Pros

• Pharmacist becomes a member of the multi-disciplinary team

• Provides pharmacy lens to areas without HA pharmacy presence

• Increased clinical satisfaction for pharmacist

• Cons

• Dependent on BC Med Review program

• Requires time commitment from community pharmacist

• Consistency of process