Q&A with Pharmacy U presenter Dragana Skokovic-Sunjic: ‘I feel obligated to provide evidence-based information and help patients make better decisions.’

Dragana Skokovic-Sunjic will be presenting at Pharmacy U Toronto on April 13, 2024.Tell us a bit about your background – education and career path as a pharmacist.I have been a pharmacist for a very long time; therefore, my career path has been long and full of unexpected curves, obstacles and opportunities. As a European graduate, I had to go through the lengthy process of getting the Canadian licence. Was lucky to work for a progressive group of pharmacies, engaging in direct patient care, getting additional certifications and expanding the scope as much as possible at the time. For the last 12 years, I have switched from community practice to primary care practice. What has drawn you to the areas of women’s health and probiotics?Both areas have something in common: confusing, undervalued and misunderstood. The interest in women’s health peaked following the initial WHI study reports when the findings were misinterpreted, hastily presented and caused unduly panic. My patients were suddenly stopping their hormonal therapy and suffering without any help of guidance. As a healthcare provider I felt it was up to me to learn as much as I can about this topic and offer help. In 2002 I jumped to the first opportunity to get certified as a Menopause Practitioner by North American Menopause Society. The learning involved in getting certified and in maintaining the credential has been valuable.Similar story when it comes to probiotics: so much misinformation, blanket statements and confusion. As a pharmacist, I needed to know the specifics: what is the evidence, is there a study to support its use, what dosage, when and to whom should it be given? When I could not find easy answers, I decided to gather the like-minded colleagues and create the easy reference tool that other healthcare professionals could use when recommending probiotics. The Clinical Guide to Probiotics was born, and it has been updated annually, used globally and continues to be one of the unique resources in this field.Have you discovered a need in your practice to help patients in these areas? What have you heard from patients, what have they told you?Many times, I have patients suffering from perimenopausal or menopausal symptoms, not even realizing the issues could be related to the hormonal changes. There is so much stigma and silence surrounding this issue. And in spite of the research done so far, in spite of the international guidelines providing great resources, we still do not address this issue appropriately. And my patients continue to suffer needlessly. It is very rewarding when they learn there is a safe place for them to discuss their symptoms, review treatment options and get help.Similarly, many if not most of my patients are taking a ‘probiotic’. When I ask them what kind, which strain or why they are taking it, there is usually no answer. I see lots of missed opportunities – patients are taking wrong probiotic strains for the symptoms they are intending to treat. Or they are taking a probiotic for no reason, wasting their hard-earned money. I feel obligated to provide evidence-based information and help patients make better decisions. How do you explain *gut health* and probiotics to the layperson? Is there growing knowledge and awareness?Gut health is becoming very popular topic. Too popular, as all social media influencers are jumping on the bandwagon and spreading half-truths, selling products, fearmongering, etc. When talking about gut health I always start with reminding patients about balanced diet, rich in fibre and food for ‘gut bugs’ or gut microbes. Only if needed, we discuss the possible use of probiotics as an intervention – for specific symptom relief, or for diarrhea prevention, or for minimizing the risk of infection, migraine, mastitis, etc. I try to emphasize – probiotics are like medications, we need to know why we use them, what kind is the best for the reason we need them, and for how long we need to take them. Has the pharmacist role changed in dealing with patients – whether it’s those interested in gut health or often embarrassing women’s issues?Over the years I have observed increased interest in learning more about topics like gut health and women’s’ health. I am very proud of my colleagues; they have been leaders and very proactive in educating patients and other healthcare professionals in both areas. And in what ways?An increasing number of my colleagues are taking additional education in the area of women’s health, more are getting credentialed as Menopause Practitioners. Many of my colleagues I mentored and assisted in applying for the certification. Over the last 16 years, working on the Clinical Guide to Probiotics, we have gathered significant feedback, measured the access and use of the resources. Pharmacists are one of the professions that accessed the resources the most. In the year 2023, we have over one million users accessing the online versions of the Probiotic Guide.In general, are you finding that pharmacists are playing a greater role in helping patients with out-of-the-ordinary healthcare needs?More and more. We have the ability to learn quickly, we have curious minds, and a very analytical approach to new information. Overall, we seem to be one of the professions adjusting to the changes and challenges very efficiently. And we are always so humble about it. We almost hide how great we are!As a pharmacist, you are involved in a number of different specialties and growing areas. Do you see specialization as the future (the present?) of pharmacy in Canada?The future of pharmacy in Canada is an interesting topic. A topic that I am not sure anyone want to make predictions about. Specialized services are definitely one of the options, along with the providing our regular services, that are often lifesaving, even if we never brag about it. We need to learn how to advocate for ourselves, how to present a unified front, and not allow the others, the non-pharmacists, decide when and how we get rewarded. Where do you see the profession of pharmacy moving in Canada?You are asking difficult questions! The pharmacy profession has changed over the last 30 years I have practised in Canada. The changes have been substantial, and we as a profession are surviving and even thriving under pressure. I am amazed by the initiatives from our younger colleagues. The passion and the expertise of the new generations of pharmacists are predictors of better future. Dragana Skokovic-Sunjic will be presenting at Pharmacy U Toronto on April 13, 2024.

Q&A with Pharmacy U presenter Dragana Skokovic-Sunjic: ‘I feel obligated to provide evidence-based information and help patients make better decisions.’

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