First of all, thank you for having invited us and for allowing me, as a community pharmacist who has worked in my field for 30 years, to come and share my thoughts with you.
The Canadian Pharmacy Association strongly supports measures to increase patient safety, including increasing capacity for monitoring, surveillance and research; and the reporting of adverse drug reactions. For professionals, for pharmacists and for myself as a community pharmacist, patient safety is a priority. Safety needs to be part of the entire chain of events that begins when the prescriber orders a medication until the results are apparent in the patient.
A strong system must be in place to ensure safe and effective use of medications—one that includes a progressive early warning system for adverse drug reactions, post-market surveillance, and education of health care professionals.
I have prepared a chart in order to explain the complexity of the process to you, which begins from the moment a problem is discovered, whether it be by a health care professional, a doctor, a pharmacist or a patient. You can see that the process is complex and has the potential for an adverse event and potential harm. You must always remember that the patient is at the centre of the process.
We begin by recognizing the problem and beginning treatment, taking into account the analysis that has been done of the case and the patient's situation. Then, we implement was is called the health care plan and the treatment objectives. The information is given to the patient, who is supposed to use the drug according to instructions while watching for signs of improvement and adverse effects. The patient finds himself or herself managing the treatment and informing the professionals of what is happening. It is a cycle that repeats itself: the patient is satisfied or has adverse effects.
Whether or not the medication is prescribed or non-prescribed, there are different actors involved in the process, including the patient.
There are many adverse reactions. According to the statistics, from 37% to 68% of adverse drug events are said to be preventable. But in order to prevent these, the right decisions have to be made at each stage of the process that I have briefly described to you. Moreover, health care professionals are being asked to make rapid decisions, often with limited information or support.
Patients have little support to be involved in the decision-making process, but increasingly, within the context we are discussing here, they are being expected to take on greater responsibility for their care, as well as that of family members.
To help health care professionals and patients make better decisions, we believe education, information and tools must be readily accessible to them.