Friday, February 22, 2019

No More Achy Breaky Bones: How Pharmacists Can Step Up to Help Patients with Osteoarthritis

This is my last week at mdBriefCase Inc. which means that I have completed one more placement, and I am all the much closer to entering the workforce as a pharmacist. Looking forward, I feel that students about to enter the profession, myself included, will have a significant influence on the way pharmacy is practiced in the future, and on the way in which services are delivered. Ideally, the incoming generation of pharmacists will shape the future of pharmacy so that it is less driven by traditional dispensing functions, and more focused on the clinical services that a pharmacist can provide. However, to reach this lofty goal, I feel that relying on the knowledge I've gained during my pharmacy school lectures is not enough. Instead, I find myself turning to continuing education (CE) programs so that I can remain up to date on the newest models for care delivery, and what pharmacists can do to better serve their patients. 

With this in mind, I wanted to focus my last blog post on the condition of osteoarthritis and a corresponding CE program that prompted my reflection on how we can optimize the clinical services pharmacists provide. 

Background on osteoarthritis
Osteoarthritis (OA) is the most common form of arthritis1. This condition affects 1 in 8 Canadians and will continue to become more prevalent as Canada’s population ages. The increase in prevalence doesn't just affect individuals with osteoarthritis - it affects the entire healthcare system as costs associated with osteoarthritis care are projected to almost triple from 2.6 billion to 7.6 billion in 20311.

Although osteoarthritis has historically been attributed to unavoidable and repetitive wear and tear at the joint, and therefore an inevitable part of ageing, current research suggests osteoarthritis is NOT a normal part of ageing but rather a systemic disorder from an imbalance between join destruction and repair1

Pharmacist’s role in osteoarthritis care
The current healthcare system is not designed to meet the population’s growing need for preventive and chronic care - two types of care that people with osteoarthritis would benefit. One possible solution to address the gap is to mobilize pharmacists to be more involved in the care of patients with osteoarthritis. 

Pharmacists are frontline, accessible healthcare professionals, who on average see patients 5 times more frequently than family physicians1. Pharmacists are ideally placed to screen for osteoarthritis and make recommendations, as patients with developing osteoarthritis may be seeking over the counter medications to treat their arthritic pain. Pharmacists can serve to identify patients with osteoarthritis who have not been formally diagnosed, and pharmacists can also help signpost patients to the most appropriate healthcare provider whether it be a physician, a physiotherapist, or an occupational therapist.

Advancing Practice Program: Arthritis & the Community Pharmacist
The importance of treating patients with osteoarthritis and the ways pharmacists can provide nonpharmacological recommendations for patients with osteoarthritis are but two of many topics discussed in a CE program on Advancing Practice, Arthritis and the Community Pharmacist. What the program made me realize is that I can step out of the boundaries of talking about just pharmaceuticals and that I can also help guide patients to utilize other modalities (e.g. braces and walking canes) to help with pain symptoms. The program also emphasized the importance of interconnected health teams so that other allied health professionals (such as occupational therapists, and physiotherapists) are also part of the interdisciplinary care.

In recent years, there has been a push for pharmacists to take on a bigger role in healthcare delivery for patients with osteoarthritis, which can benefit not only patients but also the healthcare system. Ultimately, the program introduced the idea that pharmacists possess untapped capabilities which -when used to the fullest through screening, signposting to other professions, and patient education- can improve outcomes for patients with osteoarthritis.



  1. Kelly J, Davis EM, Marra C. Practice guidelines for pharmacists: The management of osteoarthritis. Can Pharm J (Ott). 2017;150(3):156-168.
  2. Marra CA, Cibere J, Tsuyuki RT, et al. Improving osteoarthritis detection in the community: pharmacist identification of new, diagnostically confirmed osteoarthritis. Arthritis Rheum. 2007;57(7):1238-44.
  3. Marra CA, Cibere J, Grubisic M, et al. Pharmacist-initiated intervention trial in osteoarthritis: a multidisciplinary intervention for knee osteoarthritis. Arthritis Care Res (Hoboken). 2012;64(12):1837-45.