Pharmacy U presenter Carlene Oleksyn: Shingles and the pharmacist's role in preventive care

Carlene Oleksyn presents at Pharmacy U

Pharmacies are evolving to be health hubs for primary care and pharmacists are being called to step into roles involving preventive care, prescribing for minor ailments and chronic disease management. Our changing role requires a paradigm shift from being a reactive profession to a proactive one. 

I have been practising pharmacy for almost 30 years and our profession has always been a reactive one.  We wait for patients to approach us because we are busy trying to get our work done.  We will talk to a patient typically in two scenarios:  when we have to provide counselling on a new drug or a patient has a question. So, other than giving information on a drug, we wait for patients to initiate any other discussion about their health. Interaction is patient-driven. 

The problem with this approach is that patients don’t know what they don’t know.  They don’t know if they have a drug-related problem, they don’t know what is available to them that could improve their current health, their future health or reduce their risk of disease.

The need for this paradigm shift is distinctly apparent in preventive areas such as vaccination.

Patients do not know what is available to them to prevent disease and its consequences on their quality of life. Even patients who desire as much protection as they can have against vaccine-preventable diseases may not know what diseases they are at risk for given their age and or medical conditions or current medications. Patients don’t know unless we advise them, unless we, as their healthcare professionals, assess their risk and open up a discussion on what their risk is and how to mitigate consequences of disease. Patients cannot approach us or ask us about something they don’t know is a risk or an option. 

It is always disappointing when a patient comes into the pharmacy suffering from the consequences of shingles and no one told them there was a vaccine that could have prevented or reduced the severity of their current situation. We all see these patients in our practice. They start with antivirals and many end up on medications to treat its complications, such as post-herpetic neuralgia. Many of these patients are already coping with chronic disease or age-related morbidity, and adding shingles on top of this can be devastating. 

Pharmacists have the skills, knowledge and most frequent contact with patients and can make significant impacts on their lives. Shingles prevention is one of the most impactful preventive interventions pharmacists can make for at-risk patients. Developing skills in approaching patients and opening discussions is critical for prevention of a disease that can have serious consequences for the health of our patients. Developing strategies and best practices can also enhance uptake and efficiency of your vaccination services.