A message by Candy-Lea Chickite, Project Manager at FNHA and member of We Wai Kai Nation 

Have you ever looked at your medications and wondered what they're actually for and whether you're getting the best results from them? Ever thought about the potential of taking a 'medication vacation' from one or two of them? 

If you're taking multiple medications, there could be a point where the potential risks of using those medications together outweigh the benefits; this possibility is known as “polypharmacy." 

I have two medical conditions that require medication; high blood pressure and a form of acid reflux that can fiercely attack my vocal cords. Recently a friend witnessed me opening my medication organizer and commented on how many pills I take. 

When I replied that half of them are just vitamins, she scolded me, “you're not supposed to take vitamins at the same time as you take prescription medications – they can interact!" 

Having talked to many prescribing doctors about the pills I take, I'd never heard that before. So, I decided to look into it and share what I've learned so we can all increase our medication safety.

Navigating the sea of medications

If you talk to your parents or grandparents they might tell you they had one doctor and one pharmacy their entire lives. Your local pharmacist knew you, your healthcare history, your kids, your grandkids, and even your pets' names! With such a personal connection, it's natural people felt comfortable that we were receiving the proper medications and the proper dosage. 

Today, many FNHA clients may find it difficult to find a family doctor, and as a result they may not be attached to a single primary care provider familiar with their medical history. In similar ways, clients may visit pharmacists from a variety of pharmacies, whom are not fully aware of their medication history, to receive prescriptions and pharmaceutical care. 

This lack of ongoing care with the same provider(s) in today's healthcare system has contributed to the perfect storm of polypharmacy, particularly among older adults with multiple medical conditions. Many people end up taking more medications than they need. 

One innovative way to navigate the sea of medication you may be swimming in is to book an appointment with a virtual clinical pharmacist to review your medications. 

First Nations can now easily access this service at no cost through First Nations Health Benefits and Services' partnership with the University of British Columbia's Pharmacists Clinic. More info can be found in the Speak to a Pharmacist info sheet.

The clinical pharmacist can give you a complete picture of how your medications—including prescription, non-prescription, natural health products, and supplements—all work together. You can even ask about how these may affect your traditional medicines. 

At your appointment, the clinical pharmacist will work with you to make sure your medications are the best and safest for you. The initial 60-minute appointment is offered by phone or by Zoom video conference with follow-up appointments as needed.

You have the option of including your care team (physician, nurse practitioner or community nurse, family members, or advocates) directly involved in your care in your appointment. You also determine who will receive a copy of your individualized pharmacy care plan.

My experience with a Clinical Pharmacist

I set up an appointment with a University of British Columbia pharmacist and was amazed at what I learned about my drug therapy regime. The usual questions regarding demographics, diet and exercise, medication history, and general health were asked respectfully. Often when we're asked questions about drug and alcohol use, it feels stigmatizing unless it is done in a respectful, non-judgmental manner.

The pharmacist asked what I hoped to achieve from the discussion, which opened the door for the question on mixing vitamins with prescription drugs. In my case, he said it was fine to take all my medications together, which was a relief. Like most people, I remember best by taking all my “once-daily" medications at the same time! 

We discussed monitoring my blood pressure (BP) more often. The pharmacist described how to use the monitor and offered suggestions on the ideal conditions in which to test. I was impressed that the pharmacist was fully aware of FNHA's benefit plan and the coverage available for home electronic BP monitors. 

Then we discussed a personalized gradual reduction of medications I'm taking. First, since my readings have been well within the normal ranges for my age, I could slowly start to reduce my BP medications!

Secondly, I could immediately reduce the vitamin pills I take. I can take less Vitamin D when I can get it in more natural ways such as simply being out in the sun for 15 minutes. And “goodbye" to the Vitamin C pill I take because it's being replaced by a glass of orange juice in the morning every other day. I was able to reduce the number of medications I'm taking, and the details of how I can do this safely are all detailed in my very own pharmacy care plan!  

We also talked about an incredibly simple form of exercise (a five-minute walk, three times a week to start) that will provide fresh air, sunlight, support for heart health, and an overall wellness break.

Lastly, we discussed immunizations, and not just to ask about my COVID-19 booster. He raised the potential of vaccines for pneumonia and the flu, shingles (a covered health benefit for First Nations individuals 65 and older, and others who may be covered exceptionally), and a booster for tetanus.

It was a great experience that included a follow-up call to monitor the changes being made toward reducing my prescribed medications. It's been a year now and I feel like I made a significant change through the reduction of medications that simply weren't needed. Who knew that was possible?

How you can set up your appointment

Understanding and asking questions about your medications is important for your wellness and setting up an appointment to speak with a virtual clinical pharmacist is easy. A phone or video appointment can be arranged in the following ways: 

• Contacting Health Benefits at 1-855-550-5454 for support;
• Through a nurse or community health care worker who can refer and help set up an appointment;
• Through a referral from your family doctor or nurse practitioner, or First Nations Virtual Doctor of the Day; or
• Contacting the UBC Pharmacists Clinic directly by calling 604-827-2584, or online to set up an appointment with Pharmacist Tim Lim or Tiana Tilli at: http://pharmsci.ubc.ca/pharmacists-clinic​