New program helps pharmacists give better patient care with lab tests.

Abstract

The Canadian Pharmacists Association (CPhA) introduced a new continuing professional development program in March to train pharmacists in ordering, monitoring and interpreting lab tests. “Lab Tests—Ordering, Monitoring and Interpreting Laboratory Tests to Optimize Medication Management” is a response to some provinces increasing pharmacist authority to order lab tests or access lab results. Interest from the Pharmacists’ Association of Saskatchewan (PAS) first indicated that CPhA was on the right track about 3 years ago. “We were getting signals that pharmacists were going to get the authority. We wanted to meet the demand when the changes happened,” says Phil Emberley, Director, Pharmacy Innovation. PAS was the leader in the creation of the new program (known as Lab Tests), Emberley says. “Given the other work we do with continuing professional development, they thought we could take this on.” CPhA started by working with the University of Waterloo to tailor a course it offered to meet the needs of practising pharmacists. Lab Tests was reviewed by practising pharmacists and academics to make sure the content was accurate and appropriate for pharmacists. Emberley is also going to take the program himself. “It’s really meeting a need,” he says. Currently pharmacists have more authority in Alberta, Manitoba, New Brunswick and Nova Scotia, while other provinces are considering it to various degrees. “When you have access to lab test results, there’s a professional responsibility implied that you’ll know how to use them to improve the care of patients,” Emberley says. The new program is the solution for pharmacists who have access to lab values but aren’t confident in knowing how to use them. Pharmacists having access to lab values and the skills to interpret them will benefit their patients and other health care providers, as well as pharmacists themselves, says Jennifer Gibson, a hospital-based pharmacist in Winnipeg, Manitoba. Patients will benefit from having all their health care providers able to evaluate their care appropriately, while physicians will have more support from and confidence in pharmacists. Time will be saved from streamlined communications between prescriber and pharmacist once both have the same patient information, Gibson explains. She works with kidney transplant recipients and says lab values are completely integrated into everything she does. Hospital pharmacists already have access to lab values, and she sees the authority continuing to spread with expanded scope and legislation changing across the country. Gibson is also a moderator for CPhA’s ADAPT patient care skills development program, which has a lab values component that provides some basic information on common tests. A recent conversation between moderators and students highlighted the difference in authority between provinces and the need for a program like Lab Tests to give pharmacists a better understanding of lab values. Maryann Chmilar, another ADAPT moderator, is a hospital-based pharmacist in Alberta, where pharmacists have to register with their provincial association before they can order and access lab values. “Along with the privilege and efficiency comes increased responsibility for patient care,” she says. “There’s a responsibility to look at the results and come up with care recommendations. The responsibility is all the way through.” For almost every condition and most medications there is a relevant lab value that will tell you the status of the condition and the effects or side effects of the drug, Chmilar says. Knowing how to monitor and interpret lab values is key to assessing care and knowing whether adjustments are required. “You can’t fix what you don’t know about,” she says. She plans on taking the Lab Tests program as a refresher, adding that online courses are a convenient way to keep up with improvements in care. The 12.75 CEU online module course discusses pharmacist responsibility for lab tests and basic skills in interpretation. Electrolyte, kidney function, liver, endocrine, cholesterol and hematologic tests are covered. Participants can start as soon as they register and can learn at their own pace in their own time. ■