As Ontario responds to the 6th wave of COVID-19, assessment centres across Ontario have been working on improving the access and distribution of Paxlovid, an oral antiviral medication that works to prevent SARS-CoV02 from replicating. The process to release Paxlovid to appropriate patients requires a comprehensive medication review for both drug-drug interactions and renal function assessment, usually best done by a pharmacist.

However, pharmacists are not physically available around the clock when an assessment may be required. NTS Virtual Health Solutions, or better known in the healthcare space as North West Telepharmacy Solutions (NTS), is now offering remote comprehensive medication reviews around the clock and helping patients receive their Paxlovid course of therapy.

Paxlovid is a recent addition to the armamentarium that can be prescribed to patients experiencing COVID-19 symptoms. When Paxlovid is started within the first five days of symptom onset, the antiviral can prevent progression of the disease to not only reduce spread of the virus but also prevent the likelihood of the patient requiring hospitalization. However, there are hundreds of potential drug interactions which need to be assessed for requiring the comprehensive medication review.

“Paxlovid may be touted as a game changer for high-risk individuals,” said NTS director Kevin McDonald, “but the assessment takes a pharmacist’s medication expertise, knowledge, and experience to manage the drug interactions between Paxlovid and other medications the patient is taking. If you don’t do the assessment carefully, Paxlovid will either be ineffective in treating COVID or serious harm could result from one of the patient’s regular medications causing a severe side effect.”

In the James Bay Area, NTS has been involved since early February to create a process for assessing the patient’s medication history for drug-drug interactions, a process which is efficient and able to support the need at all hours, if needed.

In the James Bay Area, the NTS pharmacist lead, Theresa Crann coordinated meetings with Public Health, Community Health, Indigenous Services, the hospital leadership team along with key hospital stakeholders including the pharmacy assistants and physicians.

“As a team, we created a unique pathway that would serve the residents of the James Bay area,” said Crann. “The pathway included referral forms, best possible medication history and drug interaction summary forms, pathway maps, prepared labels for full and renal dosing for nurse dispensing, a slide shows for the entire summary of how the pathway would work, teaching modules for nurse dispensing and inventory replenishment.”

The pathway continues to evolve as Crann coordinates regular touch base meetings to address challenges and find new solutions. The NTS pharmacists continue to provide Paxlovid Interaction Checks for the covering physician Monday to Sunday from 8am to 4pm.

As assessment centres, most located within hospitals across Ontario, are now preparing for the 6th wave, many are turning to NTS for additional support to be available around the clock every day to help with the assessment.

“We are actively engaged in several conversations with our current hospital telepharmacy clients who are working hard to ensure patients are able to access Paxlovid in a timely manner,” said senior manager of business development for NTS, Sammu Dhaliwall. “We have been able to learn from the work we have done in another province where we are providing a provincial solution for all patients without family doctors.”

“We have a unique model which we know can support Ontario to get Paxlovid assessments done in a timely manner so patients can get better quickly,” said Dhaliwall. “We can offer a central toll-free number for any physician to refer patients for Paxlovid assessment across Ontario and then help direct patients to the best location to pick up their Paxlovid dose. This would also reduce the pressures on the community pharmacies who will be expected to provide the comprehensive assessment when they are already overwhelmed.”

NTS currently services over 60 hospitals across Canada and is the leading provider of hospital telepharmacy services.