Collaborative Care Award
Pharmacist. Owner, Pharm Team Holdings Corporation.
Tumbler Ridge, B.C.
Nestled within the Rocky Mountains next to hills topped with towering, white windmills lies the community of Tumbler Ridge, a former coal mining town, now home to a population with a thirst for the beautiful British Columbia outdoors.
This is a place where the modern explorer has an equal likelihood of discovering a breathtaking view one moment, and uncovering ancient footprints of dinosaurs the next. It is in this community where pharmacist Charissa Tonnesen has decided to call home, and where she has served the town’s population of 2,000 for more than 20 years.
During that time, Tonnesen has been a member of the Tumbler Ridge Museum board, a member of the Tumbler Ridge UNESCO Global Geopark board, a karate world champion, instructor and member of the Northern Rockies Karate Do board, a member of the Tumbler Ridge Community Arts Council board, a member of the Tumbler Ridge Youth Services Society board, among other community leadership roles.
"I’ve always tried to do the best for my patients and the feedback I get from my patients is what drives me to keep doing what I’m doing," said Charissa Tonnesen.
“Anything and everything, got to give it a try right?” Tonnesen mused. “I like the fact that I’m part of the community. I get to know my customers not just in the pharmacy but also out in the world. We’re all living here together, and working here together.”
Lori Bonertz, a member of Tonnesen’s pharmacy ownership group, said Tonnesen’s involvement even extends beyond her community.
“Charissa contributes to training the next generation of pharmacists. She has been a preceptor for pharmacy students from UBC for many years. She ensures that they learn not only about pharmacy but gain an appreciation for living in a small town and the available social and recreational opportunities,” Bonertz said.
“Charissa is also a board member of uniPharm Wholesale and one of her close colleagues is on the College of Pharmacists of BC. Thus, Charissa has a deep understanding of both the supply chain for pharmacy and governance of the profession.”
Bob Norman, a local senior resident, said Tonnesen is among the only health professionals he has ever called a personal friend.
“We have acted together on the stage in the Grizzly Valley Players, we’ve sang together in the local community choir, we’ve been out on dinosaur digs together,” Norman said. “In Tumbler Ridge, quite often, you’ll hear the phrase, ‘talk to Charissa.’ The seniors know that if they can’t get a hold of the doctor, it’s easier to drop into the pharmacy. You don’t need and appointment, you don’t need a phone, you can drop in and if Charissa is here, she’ll talk to you about your problems. It makes life so much simpler here.”
Her time in the community has resulted in collaborative relationships with the town’s family physician.
Dr. Charles Helm (left) and Charissa Tonnesen (right) worked together to address polypharmacy for 79 patients in Tumbler Ridge over the course of a year during the pandemic.
“She’s got credibility,” said Dr. Charles Helm, a family physician in Tumbler Ridge. “In this day and age there is so much misinformation, conspiracy theories, you need people like Charissa to give evidence-based, science-based information.”
Together, Helm and Tonnesen collaborated on the Shared Care Initiative, a program that aims to reach out to British Columbians 65 and older who are currently taking five or more medications. The idea is to perform joint medication reviews to identify whether patients are taking medications they no longer need, or medications that will negatively interact with each other.
“We identified 85 people in Tumbler Ridge out of a population of about 2,000 who met the criteria. Over the course of a year, we saw maybe two to three people a week, mostly by Zoom and sometimes by phone,” Helm said.
“Out of the 79 people we reached, we made 226 recommendations and more than three-quarters of the recommendations were to reduce, stop or taper medications. The amount of gratitude our patients had was a huge eye opener.”
Many patients, Tonnesen found, didn’t understand why they were continuing to take medications that they had been taking for years. For many, taking the medication was simply a habit.
“It was a wonderful opportunity to go through medication by medication and to ask, ‘why are you on this? Do you still need it?’” Tonnesen said.
“The patient response was excellent. People really enjoyed it, even if we didn’t make any changes to their medication, they just appreciated our time.”
One particular medication Helm and Tonnesen focused on was proton pump inhibitors.
“These are medications for reducing stomach, which is intended for short-term use but people use them long-term just because it’s really hard to stop taking the medication once you’ve been on it for a while,” Tonnesen said. “If you stop it suddenly, you suddenly have increased acid production and you have heart burn, stomach pain and it might feel worse than it felt when you started taking the medication.
“So people just think, ‘well that means I need it.’ But that just means you need to come off it a bit slower.”
For Helm, the physician, having a pharmacist who has dedicated her professional and personal life to the community of Tumbler Ridge was like meeting his soulmate.
“We just see the same thing. We agree on everything,” Helm said. “I’m just such a believer in longitudinal care – care over a long period of time. I’ve known people from when they were born to a middle age, or from middle age to their senior years, it’s the same for a pharmacist.
“All pharmacists are important but for pharmacists just starting off, they are at a disadvantage compared to someone like Charissa who has been in the community and has known the same clients for such a long time, and has all the trust and the relationships with them.”
As for Tonnesen, the idea of collaborating with her community and with fellow providers has always come naturally.
“I’ve always naturally tried to do it. In high school, I was part of the school band and you have to collaborate. You can’t make a sound that sounds good without being on the same page as everybody. Same with team sports, you just get that sense that you have to be part of a team to function,” she said.
“It’s important to understand your patients and in order to do that we need to understand the people. If you see somebody once a year or you’ve only met them once, you don’t really get a sense of that. It is that long time spent getting to know people where you get to know them.”
Norman, meanwhile, believes that despite living in a smaller, rural community, that he is receiving far better health-care than he would receive in an urban setting.
“You find that as a senior, your children sort of say, ‘mom, dad, don’t live in a small town. Move to where there is a hospital.’ But you’re not necessarily better off in a big town with a big hospital where you’re sitting in an emergency department for quite often, hours before anyone sees you.
“Here, you get seen right away if you have an emergency.”
Tonnesen said it’s the feedback she receives from her patients, such as Norman, that keep her going.
“The award is humbling in a way, but I’ve always tried to do the best for my patients and the feedback I get from my patients is what drives me to keep doing what I’m doing."