Playing prescription roulette

Joanne Gibson is under a lot of pressure as she doles out pills. The Shoppers Drug Mart pharmacist/owner knows that mixing the wrong medications can kill a person. And in the Yukon, that often comes down to guesswork.

Joanne Gibson is under a lot of pressure as she doles out pills.

The Shoppers Drug Mart pharmacist/owner knows that mixing the wrong medications can kill a person.

And in the Yukon, that often comes down to guesswork.

Most Canadian provinces have a prescription drug information system in place.

When a customer fills a prescription, their name calls up the medications they are taking, allergy issues and when and where their prescriptions were filled.

The territory doesn’t have such a system.

“There are times I filled out a prescription, then found out that the person has an allergy to it,” said Gibson.

“We rely on what our patients tell us, and sometimes patients don’t divulge information.”

There are also Yukoners dealing prescription meds on the street, who make the rounds filling prescriptions at a number of different pharmacies, she said.

“And unless we call each other up, we have no way of knowing how many places a prescription has been filled.”

It’s especially bad on evenings and weekends, when Shoppers is open later than other pharmacies, said Gibson.

“Then I can’t call them to check on a patient who’s not a regular customer.”

The elderly are most at risk.

“Seniors are our biggest consumers,” said Gibson. “And because they are older, they are more sensitive to adverse side effects (from mixing the wrong drugs).”

Across the country, seniors are taking more and more drugs, said Canadian Institute for Health Information pharmaceuticals manager Michael Gaucher.

Many seniors are on more than 10 drugs, he said.

“And as we increase the number of medications, the risk of adverse reactions to drug interactions increases.”

The elderly are more susceptible to side effects “because the drugs are metabolized by their liver, and often their liver function is not as active as when they were younger,” said Gaucher.

When a senior is prescribed more than 10 drugs, it’s sometimes hard to keep track of them all.

So when an elderly person, who’s not a regular customer, shows up at Gibson’s counter to fill a prescription and is asked what drugs they are taking, it’s not always easy to get a complete answer.

“We rely on the patient and the doctors,” she said.

But there have been times when patients have arrived from emergency to fill a prescription and Gibson has learned about another medication they are taking and called the doctor.

“And the doctors didn’t know about that prescription,” she said.

“The patient didn’t tell them.”

With a drug information system, everything would be in the system.

“It’s important for us to see (seniors’) complete profiles so we know what drugs they are already taking,” said Gaucher.

A drug information system is essential, he said.

In 2005, a CBC investigation found as many as 3,300 seniors were dying annually from adverse drug reactions across the country.

Alberta has had a drug-information system for at least five years, and BC’s Pharmanet keeps track of every prescription that’s dispensed in the province. In 2007, over 47 million prescriptions were processed on Pharmanet and the system flagged more than 24 million potential drug interactions, according to its website.

“The Yukon is definitely way behind,” said Gibson.

Last year, the territory spent more than $3.5 million on prescription drugs for its 2,600 seniors.

The drug plan, which covers all prescription costs, is one of the best in the country.

“And we’re seeing more and more seniors and people bringing their parents here,” said Yukon chief medical officer Brendan Hanley.

“The access to health care is better here.”

But rising drug costs and growing demand could threaten Yukon’s health-care system.

“There is concern over rising health-care costs,” said Hanley. “We need to remain vigilant.”

Prescription drugs cost Canadians roughly $25.4 billion in 2009, according to a report by the Canadian Health Institute, titled Drug Use Among Seniors on Public Drug Programs in Canada.

And seniors accounted for 40 per cent of that spending. But they make up only 14 per cent of the population, said the report.

More and more seniors are taking drug cocktails, said Hanley.

When a senior visits the doctor with angina, it’s not uncommon for them to leave on five different drugs, he said.

“And there is more of a tendency now to use drugs for risk reductions.”

There is a need for a drug information system, added Hanley.

“To be able to bring up a patient’s (prescription history) on screen – that would be ideal.”

Contact Genesee Keevil at

gkeevil@yukon-news.com

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