Pharmacy U presenter Kristen Watt: Pharmacists and COVID-19 antiviral therapy

Kristen Watt will be presenting at Pharmacy U Toronto on April 1, 2023

As much of the world moves on from COVID, health-care professionals continue to face challenges created by the novel coronavirus, daily. The landscape shift due to vaccines has bee key in reducing the severity of COVID-19 infections in many patients. Utilizing antiviral therapies to reduce the severity of COVID-19 illness in patients who would benefit is part of the current phase of pandemic management.

Access to COVID-19 antivirals has improved in Ontario since late 2022.The goal is to ensure those Ontarians who would benefit most from the medication have an opportunity to receive it.With access to family doctors an increasing challenging for Ontarians, many who have no family doctor, community pharmacists may be available to bridge the gap.

Adding this into the workload of already overworked and, quite frankly, exhausted community pharmacists is a big ask. But it may be the driver of a bigger paradigm shift in community pharmacy, moving the pharmacist out of the assembly line of dispensing and into the clinical role for which we all trained. Timely, accurate and safe pharmacotherapy management can be offered with proper staff support.

The community pharmacist is well positioned to recognize the patient population who would benefit most from COVID-19 antivirals, is able to employ strategies to address DDIs related to this therapy and contribute to improved patient outcomes using their unique knowledge and skills.

Prescribing and dispensing data tell us there remain treatment deserts in the eligible population. For Ontario pharmacists, this was the first (aside from rarely used smoking cessation meds) prescription medication we were able to prescribe. And what a medication to start with. The significant CYP enzyme inhibition purposely employed in the combo also yields many significant drug interactions with patients' established medication regimens. But who better to manage these than pharmacists? This is also a therapy that has renal dosing guidelines. Community pharmacists across the province are slowly onboarding to clinical viewers to gain access to patients' lab values. Guidance also exists to help pharmacists without lab value access make informed clinical decisions.

Proactive assessment & planning for prescribing may be part of the answer. Patient interactions like MedsCheck are a perfect place to identify those who would benefit from a Paxlovid plan. I suggest we consider the plan early to reduce the pressure on assessment, prescribing, dose adjusting, therapy modifying and lab analyzing that happens with a positive test. Also, these proactive conversations are likely to drive patients to know to call us when testing positive, may reduce the burden of disease on our highest risk patients and have meaningful outcomes in morbidity and mortality.

Leaving this session, attendees will feel more comfortable with the current COVID-19 antiviral landscape and feel ready to assist their patients in accessing these medications.

Kristen Watt will be presenting at Pharmacy U Toronto on April 1, 2023