Saskatchewan

Regina pharmacists fail to screen drug interactions

A hidden camera investigation is raising questions about the safety of a trip to the drug store in Saskatchewan. A months-long CBC News-Marketplace investigation revealed Regina is one of the worst cities when it comes to pharmacy staff following screening procedures for dispensing behind-the-counter drugs.

College of Pharmacists ‘disappointed’ with results of hidden camera investigation

A secret shopper took hidden cameras into seven Regina pharmacies and asked for Schedule 2 drugs to see if staff were following the proper procedures. (CBC/Marketplace)

A hidden camera investigation is raising questions about the safety of a trip to the drug store in Saskatchewan.

A months-long CBC News-Marketplace investigation revealed Regina is one of the worst cities when it comes to pharmacy staff following screening procedures for dispensing behind-the-counter drugs.

“It is very disappointing,” said Ray Joubert, the registrar for the Saskatchewan College of Pharmacists.

A secret shopper took hidden cameras into seven Regina pharmacies and asked for Schedule 2 drugs to see if staff were following the proper procedures.

At five different drugstores in Regina, a Marketplace tester asked for Palafer, an iron supplement that can be hard on the stomach and can also lessen the effect of some antibiotics if taken at the same time. (CBC/Marketplace)
According to a Saskatchewan bylaw, Schedule 2 drugs don’t require a prescription but are kept behind the counter to ensure a pharmacist provides counseling.

At five different drugstores in Regina, a Marketplace tester asked for Palafer, an iron supplement that can be hard on the stomach and can also lessen the effect of some antibiotics if taken at the same time. 

In each test, the pharmacy staff did not ask why the shopper was buying the product, if the individual was taking any other medications nor provide directions for how to take it before selling it.

“If that’s what happened, it’s disappointing, because that’s not what our standards expect,” said Joubert.

“Our standards expect the pharmacist to engage with the patient in determining whether or not what is being requested is indeed appropriate or if it is and it could be supplemented by something else.”

The college says it conducts regular inspections and audits of pharmacies.

But there is no central tracking system for medication errors in community pharmacies within Saskatchewan. 

According to the regulator, some pharmacies may track errors, but they don’t always evaluate why they happened or implement a plan to fix the problem.

Saskatchewan fares better on codeine test

Saskatchewan fared better when the secret shopper asked pharmacy staff for Tylenol No. 1, which includes codeine. (CBC/Marketplace)
Saskatchewan fared better when the secret shopper asked pharmacy staff for Tylenol No. 1, which includes codeine. 

Codeine is a narcotic that can interact with other medications, which can increase the effect of the drug on the system.

When the test was conducted at a Shoppers Drug Mart in Regina, the pharmacist took over the sale and asked the tester if they had taken the drug before, if they had any allergies and for a health card to complete the sale. However, they did not screen for interactions with other drugs.

Soon after, the shopper tested a nearby independent drugstore, and again, the pharmacist asked for the shopper’s health card. In this case, the pharmacist would not sell the drug when he saw on the tester’s file that she had just purchased the drug at another pharmacy.

Saskatchewan has a database that lets pharmacy staff record purchases of behind-the-counter ‘exempted codeine products’ using a customer’s health card.

It is a monitoring tool for pharmacists to determine if the customer has bought the drug within the last 30 days. If the customer has recently bought the drug, the customer can be refused the sale. 

“The whole goal is to prevent inadvertent addiction to these substances and of course to prevent diversion and abuse,” said Joubert.

The College of Pharmacists is working with the provincial government to make using the database mandatory. 

College says more can be done

Ray Joubert, the registrar for the Saskatchewan College of Pharmacists, acknowledges the Marketplace tests indicate there is still more that could be done. (CBC)
However, Joubert acknowledges the Marketplace tests indicate there is still more that could be done.

“Maybe we need to have a look at what the problems are and engage other stakeholders - those who have an influence in how pharmacies are operating and so on to find out what is really going on out there and what can be done from their point of view,” said Joubert. 

“In other words, try to seek some method of voluntary compliance within the profession.“

Joubert said the college is working on a program, which is in the pilot phase, called Community Pharmacists Advancing Safety in Saskatchewan (COMPASS). 

Instead of relying solely on auditing and inspections, Joubert says COMPASS is working to embed a culture of safety and safe medication practices through self-assessment and incident reporting in pharmacies.