Thank you, Madam Chair, and thank you to the committee for the invitation to present today.
My name is Jeff Poston, and I'm the executive director of the Canadian Pharmacists Association. With me is Dr. Phil Emberley, CPhA's director of pharmacy innovation. We are the national association representing pharmacists in all areas of practice. CPhA is also Canada's largest publisher of drug and therapeutic information for health care professionals. We provide evidence-based information to support doctors, nurses, and other health care practitioners in clinical decision making.
By 2021, the population of Canadian seniors is expected to reach 6.7 million. Currently, 74% of Canadians aged 65 or older are taking at least one medication. In 2008 over 75% reported having at least one of eleven chronic diseases, which included cancer, chronic pain, diabetes, heart disease, and depression.
Additionally, we spend about $833 per person per annum on drugs, making us one of the highest spenders among OECD countries. Maintaining affordability and obtaining value for money are key challenges. Evidence also tells us that elderly people are more likely to experience drug-related problems and adverse reactions to drugs. This is as a result of being on one or more medications due to a number of chronic diseases, and to the diminished capacity of the body to handle drugs as we age. Chronic disease also poses challenges in younger people, particularly with respect to continuation and adherence to drug therapy.
Pharmacists are the medication experts in the health care system. Today, pharmacists receive at least five years of university education, including training in patient care settings. Recently, most provinces have passed legislation that provides pharmacists with a degree of prescriptive authority, which allows them to change a patient's drug therapy to improve patient outcomes. This is obviously done in collaboration with the patient's physician and other members of the health care team. I shall say more about collaborative care later.
Given such legislative change, pharmacists, as both medication experts and the most accessible health care professionals, are ideally positioned to assist in delivering services to the aging population. Pharmacists can play a significant role in chronic disease management by providing comprehensive medication management. This involves critically assessing patients and their medication regimen for appropriateness, effectiveness, safety, and convenience; identifying any problems that may exist with drug therapy; and developing a plan to fix them. This plan has to be shared with the patients' other health care providers, and then pharmacists must follow up with the patients to make sure that desired outcomes are achieved.
Research has demonstrated that such services save money and help patients. An estimate by the Ontario Pharmacists' Association reported that expanded scope services would save $72.4 million a year in health care in Ontario in one year alone. In a large U.S. study, pharmacist-led medication management services provided a return on investment of $1.29 for each dollar invested. Furthermore, over 95% of surveyed patients agreed or strongly agreed that their overall health and well-being had improved as a result of these services.
In addition to the new legislation, pharmacists are also working in new collaborative models of practice, such as family health teams. Studies have shown that pharmacists in such teams can play a key role in managing diseases such as high blood pressure, raised cholesterol, asthma, and other chronic conditions. Improving drug therapy through collaboration leads to fewer emergency room and physician visits, and thus allows for potential health care savings. As we go forward, ensuring a pharmacist presence in inter-professional health care settings is an important component of the care that we need for our aging population.
In June 2010, this committee, in its report dealing with health human resources, offered several recommendations aimed at enhancing inter-professional collaborative care, including the pursuit of greater collaborative care for federally served populations. We would support these recommendations, and suggest that the committee may consider repeating these recommendations in its final report.
Investment in electronic health records and e-prescribing systems is also necessary to support collaborative care and improvements in the continuity of care.
We are encouraged to see provinces beginning to fund new pharmacy services. For example, in Ontario, the government is paying pharmacists to help patients quit smoking and to optimize drug therapy for patients on multiple medications, those receiving home care, and patients with diabetes. Pharmacists are also funded to review patients' drug treatments in Quebec, Saskatchewan, and Nova Scotia. British Columbia is currently funding a pilot study.
We recommend that the federal government explore funding of pharmacist medication management services as part of federal employee health care programs and for clients of the Federal Healthcare Partnership and the first nations and Inuit health branch.
The federal government already has a number of programs and investments in place to address chronic disease and aging, such as the federal tobacco control strategy and the Canadian diabetes strategy. We've worked closely with the government to provide programs to develop pharmacy services and improve patient outcomes with respect to smoking cessation and diabetes management. CPhA would encourage the government to continue to strengthen its support for those programs.
The accessibility of pharmacists in the community setting also positions them well to play a major role in the early detection and prevention of disease. This involves screening for diseases such as raised blood pressure, the provision of immunizations, smoking cessation, and promoting wellness and healthy lifestyles. Recognizing the potential for pharmacists to provide vaccination services, governments in British Columbia, Alberta, New Brunswick, Manitoba, and Nova Scotia have passed legislation to enable pharmacists to perform such services. These developments allow Canada to be able to better respond to public health challenges.
Research has shown that pharmacy-based screening programs reduce hospital admissions. As an example, a large Canadian study published this year showed that pharmacy-based blood pressure screening programs in 39 communities in Ontario resulted in a 9% reduction in hospital admissions for heart attack and heart failure in patients 65 and older.
As we move toward the renewal of the 2004 health accord, CPhA would urge governments to make health promotion and disease prevention a cornerstone of the new accord in 2014, particularly as we believe this will be a reflection of the needs of the aging population.
I'd like to touch briefly on the Canadian Pharmacists Association's role as a publisher of drug and therapeutics information. Our online service, e-Therapeutics+, provides doctors, nurses, and pharmacists with an up-to-date, evidence-based source of drug and therapeutics information that helps them make better decisions to support improved patient outcomes.
CPhA would like to work with Health Canada and Canada Health Infoway to increase point-of-care access to this resource through integration in electronic health record applications, including e-prescribing.
In conclusion, pharmacists have a key role to play in managing and minimizing the impact of chronic diseases on Canada's elderly. By working to help strengthen that role, either unilaterally in partnership with the provinces and territories or with pharmacists themselves, the federal government can play a lead role in helping Canadian seniors access the quality care they rightfully deserve.
Thank you very much.