The Pharmacist’s Approach to Heartburn Warren A. Meek RPh, BSc (Pharm) FFIP Halifax, Nova Scotia, Canada Warren Meek is a practicing community pharmacist in Nova Scotia, Canada, an Executive Committee member for the Community Pharmacy Section FIP, and an experienced member of the Boards of provincial, national and international pharmacy organizations. He has participated in various inter-professional, pharmacy practice, and pharmacy policy research, from cardiovascular health to pharmaceutical care and collaborative pharmacy practice. Warren has a comprehensive understanding of pharmacy practice issues in different countries, gained through his participation in FIP, and his volunteer activities in Africa. The accessibility of pharmacists generally offers the public the opportunity to have their minor ailments1 assessed: to receive advice, treatment options - non-pharmacological or pharmacological, or to be referred to another health care provider. Superficially, heartburn – a burning sensation of mid-chest discomfort radiating to throat and neck – may be considered a minor ailment. Regardless of the number of people reporting heartburn symptoms, most of them indicate a waxing and waning of symptoms that may or may not require some treatment option. However, proper triage will help confirm the absence or presence of underlying health issues. In addition to applying the Connect and Care2 concept of greeting, listening and assisting the patient with heartburn (Figure 1), the role of the pharmacist, through appropriate questioning3 (Figure 2) will be to ensure that the patient receives the best treatment option or referral. The patient may have only a single complaint – heartburn – or the heartburn may be one complaint that leads to a broader discussion. In addition, the role of the pharmacist (Figure 3) is to ensure the responsible use of medicine, optimize patient safety, and guide the patient in what to expect from the elected treatment options4 Figure 2 Questions to consider when assessing for Heartburn 3 Figure 3 The role of the pharmacist 4 If the patient has been referred to the pharmacist by another healthcare provider, the pharmacist should clarify the patient’s understanding of, and support that referral. If the patient is seeking pharmacist advice on a primary care basis, the assessment of the patient will include frequency of attacks, intensity and duration. Various patient assessment aids, either electronic or paper, are available (see Figure 11 at end). The patient’s assessment of symptom severity will range from ‘nuisance’ to ‘disruption of daily quality of life’. One key consequence of heartburn, for some patients, may be sleep interference. The pharmacist will query the patient on risk factors5 (Figure 4). The pharmacist may wish to not only list the risk factors, but also to explain in what way they may affect heartburn. Figure 1 Connect and Care Model 2 World Digestive Health Day WDHD May 29, 2015 WGO HANDBOOK HEARTBURN: A GLOBAL PERSPECTIVE 25
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