Read time: 8 minutes
Pharmacy professionals across Alberta provide health care to at-risk populations, sometimes in difficult circumstances. Full Scale caught up with two pharmacists who go the extra mile for individuals with complex needs.
Lidia Molinara, Elsafadi Pharmacy, Edmonton
When Edmonton’s Hope Mission was first established in 1929, its purpose was to serve meals to those hit hardest by the Great Depression. Today, nearly 100 years later, the Hope Mission provides more than just food to those in need. The Hope Mission has expanded its services to include emergency care—including health care—to those experiencing houselessness.
Edmonton pharmacist Lidia Molinara helped establish HopeHealth, which provides compassionate, barrier-free health and social supports to those in need.
“We have pharmacists who visit the site and work in a multidisciplinary team which includes nurse practitioners, registered nurses, licensed practical nurses, and healthcare aides,” said Lidia. “We meet with the patients identified by the nursing team who require either a medication or pharmacy consultation. The nurse practitioner works with the pharmacist to determine the need and, in some cases, prescribe medications. Sometimes, we identify things like vaccines or wound-care issues—it’s not always just medication related. Sometimes it has to do with qualifying for medications because some clients don’t have coverage and that’s why they stopped taking their medications, so we help determine those barriers.”
Mohamed Elsafadi, Lead Clinical Pharmacist, and a team of pharmacists visit the Hope Mission shelter in downtown Edmonton weekly. They also contribute to the 24/7 Health Shelter, which helps individuals who are medically stable but require ongoing health support from a multi-disciplinary health team, including pharmacists.
“We are on call 24/7 to answer the questions that the nursing team may have,” said Lidia. “Sometimes we’ll have to go to the site in the middle of the night, because they don’t have medications they need, so we will go in, fill the prescription, and deliver it.”
Lidia and her team also created regular injection schedules and administer opioid agonist therapy for people in recovery. They meet with clients and chat about their health journeys. They will discuss what over-the-counter medications they should or shouldn’t be purchasing to avoid interactions with their regular medications. Lidia’s pharmacy also employs a nurse practitioner who visits the Hope Mission facilities weekly to help close any gaps with patients who have complex needs.
The fact that all these services are needed at the Hope Mission is an indicator of the obstacles so many people face when accessing health care.
“Many clients are seniors with low mobility, some of them have been in accidents, and so there are situations where they don’t have access to labs, and they don’t have family doctors,” said Lidia. “Sometimes they don’t have identification and to access the healthcare system without ID is very difficult. A social worker is now on site to help get these people covered under social services.”
Perhaps the biggest barrier for clients of the Hope Mission, says Lidia, is the lack of trust they have in the health system itself.
“Sometimes there are mental health reasons, where it’s not comfortable for them to go to a regular health facility or family physician’s office,” said Lidia. “And then when they go see the doctor, sometimes the physicians don’t quite understand their mental health status, so the patient is just prescribed something and they leave, they fill it at the pharmacy, and they don’t take the medication.”
Lidia acknowledges there are many challenges to providing pharmacy services to clients of the Hope Mission. However, she sees it as her responsibility to not only the clients, but the community as a whole.
“We knew there were situations where some of these clients were going to the emergency department because they had nowhere else to go,” said Lidia. “As pharmacists, when we have access to clients, we can help stabilize some of their concerns, so they don’t end up back in the hospital, which affects the whole community. If we can help clients avoid going to hospital, then that frees up the space for someone else’s emergency.”
Despite the challenges of working with this population, Lidia finds the work rewarding.
“We spend quite a bit of time with the clients to build a rapport and trust,” she said. “You get to know the clients, and you want to see them feel better. We attend the graduation ceremonies and see the two-year progression for them. You see them start to put the pieces of their life together. Of course, we’re only a small part of that recovery, but it’s nice to know we had a part in it.”
Pharmacy teams across Alberta provide health services to at-risk populations. Based on Lidia’s experience, she offers this advice to her peers:
“I think we have to look at this population through a different lens where we have to become a little bit more involved in their care,” said Lidia. “We have to sit with them and try to gain that rapport and trust. It’s not just about filling Suboxone and leaving. Truthfully, I think that’s where we as pharmacists need to do a better job. There’s a real impact we can make in helping them stay on track.”
James Frobb, Gaetz Avenue Pharmacy, Red Deer
Just off of Red Deer’s main thoroughfare, sandwiched between a medical clinic and a walk-in clinic, sits Gaetz Avenue Pharmacy. James Frobb has been the licensee of the pharmacy for two years and has done a lot of work to transform the team, the workflow, and the space to suit the needs of the community.
“One of the main goals was redesigning the pharmacy so pharmacists become the first point of contact for patients instead of being hidden behind the dispensary,” said James. “We improved patient flow, created more dedicated consultation spaces and privacy barriers, and organized the workflow so pharmacy technicians can work more independently while pharmacists are providing more direct patient care activities. It has made our team more efficient and allows patients to access clinical services much more naturally as part of their visit rather than needing to book an appointment to see us.”
James also updated the pharmacy’s policies and procedures to take advantage of the physical renovations and make the type of care he envisioned possible.
“We reviewed many of our workflows to ensure pharmacists and pharmacy technicians are practising to their full scope while maintaining consistency in patient care,” said James. “We standardized clinical documentation, clarified responsibilities for prescribing and follow-up, developed protocols around services such as opioid agonist therapy (OAT), and updated privacy and workflow processes to better integrate technology, which I think is important. It’s challenging to change entire workflows in a in a system that people have been so used to doing for a while, but I think with consistency, people will learn what you’re trying to do and see the vision for the place. Our goal is to make high-quality care consistent regardless of which team member interacts with the patient.”
A significant percentage of the patients who walk through Gaetz Avenue Pharmacy’s doors on a regular basis receive OAT, which James says has its challenges, but is equally rewarding.
“One of the physicians at the medical clinic next door was one of the early adopters of OAT, so it’s the patient population we serve,” said James. “People struggling with substance use often face significant barriers to health care and unfortunately can experience stigma within the healthcare system. Pharmacists are uniquely positioned to build trusting, long-term relationships through frequent contact with patients. OAT isn’t simply about dispensing medication. It’s about providing stability, reducing harm, supporting recovery, and being consistent healthcare professionals someone can rely on during a challenging time.”
While providing OAT, James has seen positive transformations with some patients, while other struggle.
“It’s about persistence and consistency,” said James. “We just keep trying. Eventually, there is hope that we persevere. We’ve become a trusted resource for patients with complex medical and social needs by providing continuity of care and coordinating with other healthcare providers when needed.”
James offers this advice to other pharmacy teams who provide OAT services to patients:
“I would lead with empathy, but don’t underestimate the importance of boundaries. Patients experiencing addiction, mental health issues, or housing instability often need consistency just as much as compassion. Building trust takes time, and sometimes the most caring thing we can do is provide clear expectations while continuing to treat every patient with dignity and respect. Also, don’t try to do it alone. We work closely with physicians, mental health teams, social services, and our own pharmacy team because when there are multiple points of contact and different viewpoints from different providers, it often leads to better outcomes. That can include family members, care partners, or other healthcare providers in a patient’s circle of care—someone the patient trusts to check in on them and see how they’re doing.”
