March – Pharmacy Appreciation Month

The role of a hospital pharmacist differs significantly from that of the pharmacist you see in your local pharmacy. A hospital pharmacist is an essential part of the healthcare team. They provide daily guidance to doctors, specialized nurse practitioners, and other members of the multidisciplinary team on medication management. Their work includes pharmaceutical services and care tailored to the hospital's various care units.

When on duty in a dispensing role, the hospital pharmacist must validate prescriptions to ensure the prescribed medications are safe for the patient. In a clinical role, they verify that the medications prescribed upon admission match those the patient takes at home. During the hospital stay, they optimize the patient's drug therapy, adjust doses based on the patient’s needs, propose solutions to manage drug interactions and side effects, and meet with the patient to provide medication education.

“Hospital pharmacists use pharmacokinetics on a daily basis - a discipline that studies how drugs move through the body. Targeted pharmaceutical interventions can be made at each stage of the process to optimize treatment and ensure the safe use of medications,” says Maéva Blot, who works in geriatrics and cardiac surgery. “There are also drugs with what is called a narrow therapeutic index, which require precise adjustments based on blood tests. If the dose of these medications is too low, they are ineffective. If the dose is too high, they become toxic,” she explains. “Some pharmacists also have advanced practice agreements, which allows them to independently prescribe medications in certain care units,” she adds.

Maéva also points out, “In geriatrics, we often meet with patients’ families during their care to inform them about medication changes. With age, some medications may become potentially inappropriate and have harmful effects on the health of older adults. It is therefore crucial to weigh the pros and cons of each medication and adjust or reduce doses to prevent hospital admissions caused by overmedication.”

The pharmacist specialized in pediatrics may sometimes need to present medications to children in different forms. “It's well known that children generally don't like to take medicine, and some of them, frankly, taste bad. It often happens in a pediatric pharmacy that we present the medication in syrup form, to which we can add flavor. This is one of the advantages the pharmacist has in a pediatric setting,” says Lauriane Ginefri, a pharmacist at the Montreal Children’s Hospital. “By definition,” she adds, “the pediatric patient group extends up to 18 years old. An 18-year-old is considered an adult when it comes to medication. Their medication reflects that. Otherwise, doses are often based on weight. So, we have to work with a wide variety of patients. Furthermore,” adds Lauriane, “Consent for care, based on health status can be given by the patient starting at age 14. Therefore, pharmacists in pediatric settings often need to adopt a variety of communication approaches.”

Finally, some pharmacists work in the field of clinical studies. In this area, study protocols are followed to the letter, and pharmacists must ensure that the medications taken by patients meet the study’s criteria and are compatible with the drug being studied. These pharmacists work closely with researchers from the Research Institute of the MUHC or the MUHC itself, as well as private pharmaceutical companies. 

This Pharmacy Appreciation Month, let’s celebrate the indispensable work of all pharmacists at the MUHC!