Craig Plain was enjoying a pleasant and rewarding career as a manager at a corporate pharmacy in South Surrey/White Rock when he was approached to help launch a brand new clinical pharmacy practice in the heart of the Downtown Eastside in 2015.
Introduced by a mutual pharmacy colleague to Bobby Milroy, director of Pier Health Resource Centre, Plain was intrigued by the centre’s unique clinical approach. “I realized this was a new and exciting career path that could really make an impact not only in the Downtown Eastside, but an interesting opportunity to expand the role of pharmacy,” says Plain.
With the aim of addressing the needs of a homeless and at-risk population – many of whom are daily or weekly pharmacy customers – Pier Health provides mental health and chronic disease outreach support, with a strong emphasis on solving drug therapy problems both within the pharmacy as well as through regular outreach within the local community.
According to Plain, this often starts with a simple conversation. Customers are invited to sit at one of the pharmacy’s intake booths and sit face-to-face with a member of the pharmacy team to discuss their health background and medication needs, but also just to chat about their day or week.
“The best part of my day is sitting at one of the intake stations,” says Plain. “You never know who’s going to come in next. Many want to talk and share their story and share how they’re doing.”
For many, the focused, personalized care has been life changing. “Craig is different than any other pharmacist I have met in my 20 years of using daily pharmacy,” says pharmacy customer Irene Mountain. “His compassion and advice has helped me get into a great rhythm in my life; Craig is an important part of my daily routine.”
In his initial conversations with patients, Plain is often sparked to probe further in certain areas, referring patients back to their doctors, resolving recurring drug therapy issues through comprehensive medication reviews and arranging for the emergency treatment of patients in urgent need – even driving patients to the hospital himself if need be.
“Many of our patients weren’t being recognized,” he says. “Nothing was being resolved, open wounds not being addressed, people being refused service because of their coverage. It’s a little shocking to me still.”
In addition to managing the concept pharmacy and working one-on-one with patients, Plain is also the first pharmacist in BC to administer depo anti-psychosis injections on site, through a pilot project with St. Paul’s Hospital Department of Psychiatry. Having administered nearly 40 injections to date, Plain’s dedication to this expanded scope of pharmacy practice allows patients greater flexibility in receiving their vital injections, increasing medication adherence success rates for this extremely at-risk group.
“Craig compassionately and competently administered medication to individuals deemed dangerous, aggressive and afflicted by acute psychosis,” says John Shaske, pharmacy manager/owner of Howe Sound Community Pharmacy, on which the Pier Health clinical model is based. “Craig has single-handedly expanded the scope of community pharmacy in BC and done so under the most intense and dynamic circumstances possible.”
In his role, Plain strives to make a difference – not just to his daily patients, but also to the Downtown Eastside community as a whole. Working in partnership with the UBC psychiatry research team, his comprehensive documented clinical work has provided the team with invaluable research and statistics on the local population, in an effort to address the community’s ongoing needs through targeted, accessible health-care services.
“I think it’s exciting to feel like we’ve filled a need in the Downtown Eastside,” Plain notes. “I could see this model working in other areas [of BC] and having this service would be very beneficial to many communities.”
Overall, he hopes his work inspires others in pharmacy to pursue an expanded scope of practice in their careers. Having mentored a dozen pharmacy students since joining Pier Health, Plain strives to expose his students to a unique and meaningful model of pharmacy.
“I can honestly say Craig’s approach to community pharmacy has reshaped my vision of what is possible in my career,” says graduating pharmacy student Jarred Kelly. “He is an inspiring leader and a great teacher.”