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Pharmacy & Formulary

The Pharmacy & Formulary Review Committee determines which medications are essential in the care and treatment of patients with kidney disease.

Formularies

We have developed three formularies:

Guidelines

Guidelines, protocols & resources

Drug removal during hemodialysis affects drug effectiveness, the administration timing around the dialysis schedule, and the needs for supplemental dosing. This website contains dialyzability data from a literature review of pharmacokinetic studies in intermittent hemodialysis, pharmacokinetic parameters of the drugs, along with drug dosing recommendations in intermittent hemodialysis.

Poster presentation and chart

 
Sevelamer of Lanthanum Criteria and Application Forms

Please note that the forms require the signatures of both (a) the nephrologist or renal clinical pharmacist, and (b) the renal dietitian (confirming dietary compliance).

Please also note the following guidelines on prescription quantities and refills.

 
Malnutrition is common among patients in stages 3 to 5 of chronic kidney disease (CKD). Maintaining or improving nutritional status is a challenge, and it is often necessary to rely on nutritional supplements to optimize intake.

The BC Renal Agency (BCPRA) funds nutritional supplements for all registered kidney patients, both those on dialysis and those in earlier stages of the disease. To access the renal nutritional supplement program, kidney patients at nutritional risk must registered with BCPRA through the PROMIS database.

The nutritional policy document below is a guide for registered dietitians and pharmacy partners.

Nutritional Supplement Policy

Replavite/Renavite
The full position statement and summary below outline the recommend use of Replavite/Renavite in adult non-dialysis. These documents were developed by an ad-hoc committee of the BC Renal Dietitians Practice Group and were approved by the BCPRA Pharmacy and Formulary Review Committee.

Full position statement

Summary


 
Med Reconciliation

The BC Renal Agency and the health authority renal programs were the first in Canada to initiate medication reconciliation (or "med rec") for kidney patients across the continuum of renal care – from clinic, to admission, to transfer, to discharge, and back to the clinic.

Kidney patients, with their needs for multiple medications and frequent prescription changes, are at a higher risk than most patients for medication errors. In addition to improving patient safety, med rec supports easier hospital admission and discharge, providing patients with up-to-date medication lists, and better drug-use evaluation at patient, prescriber and agency levels.

In addition to being recognized by Accreditation Canada as a “leading practice,” the BC renal med rec program has received the following awards:

An Excellence in BC Healthcare Award of Merit (Collaborative Solutions category) from the Health Employers’ Association of BC in 2010

An Excellence in Quality: Across the Province award from the BC Patient Safety and Quality Council in 2011

A “Trailblazer Award” from Canada Health Infoway for the use of PROMIS in medication reconciliation. The award was part of Infoway’s ImagineNation Outcomes Challenge.

Reports & tools

BCPRA has developed a number of reports and tools to assist programs with medication reconciliation:

 

 

For more information about the BC renal med rec program, contact Dan Martinusen or Dr. Monica Beaulieu.



Pharmacies

 

The BC Renal Agency partners with a number of community pharmacies to provide a funded formulary of medications for patients registered with BCPRA.

In most cases, one partner community pharmacy is located near each hemodialysis unit in the province. Advantages of this partnership include:

  • a clear understanding of the expectations of both patients and BCPRA
  • a consistent approach to patient care
  • an opportunity for pharmacists to get involved in the specialty care required by nephrology patients

Note: One pharmacy, Macdonald’s Prescriptions in Vancouver, provides an enhanced level of service to BC kidney patients. Two of the most costly therapies – erythropoeitic replacement hormones (Erythropoeitin and Darbepoietin) and intravenous iron preparations – are distributed throughout the province by Macdonald’s. BCPRA chose to partner with one pharmacy for these products due to storage and shipping requirements, as they comprise a significant portion of our budget.

For community pharmacies

For information on how a patient can register for BCPRA funded medications, contact the BCPRA at 604-875-7340 or by email.

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