For Dr. Jamie Falk [B.Sc.Pharm/97], asking the right questions has always been more important than finding quick answers.
“I’ve always been skeptical of easy solutions,” Falk says. “If we want to improve health care, we need to take a step back and ask: Why do we do things the way we do? Does the evidence support it?”
Falk, who is from Steinbach, Man., earned his bachelor of science in pharmacy at UM in 1997. After several years as a community pharmacist, he completed his doctor of pharmacy degree at the University of British Columbia.
In 2013, he returned to the UM College of Pharmacy, where he is now an associate professor.
Falk is passionate about applying research evidence to the management of chronic diseases, and about bridging the gap between prescribing guidelines and real-world practice.
“Don’t simply have faith in the guidelines,” he tells prescribers and students. “Think about whether the guidelines can be applied to the patient in front of you.”
Research sometimes uncovers a striking disconnect between guidelines and patient reality. For a study published in 2020, Falk’s team used anonymized Manitoba health data to track more than 42,000 older adults who received a first prescription for an oral bisphosphonate to prevent osteoporosis-related fractures.
Canadian guidelines say patients should stay on these bone-strengthening drugs for at least one year to derive any benefit, and for at least three years to get significantly reduced fracture risk.
The study found that more than half of users quit taking the medication before the one-year mark. Falk and his colleagues titled their research poster about it Reality Check.
“One theory was that patients went off these drugs on their own because they were never really engaged in the decision to be on them. Shared decision-making with the patient is something I talk about all the time.
“When we offer an evidence-based medication to a patient, we should discuss with them the actual benefits and harms, using numbers.”
In the case of bisphosphonates, Falk believes patients may have gleaned from Google that these drugs are associated with an extremely rare, serious side effect: osteonecrosis of the jaw.
The Internet highlights scary anecdotes – “This happened to my mom!” – that have a distorting effect on the true risks versus benefits, he says.
The professor knows that time constraints often prevent prescribers and pharmacists from having informative decision-sharing conversations with patients. But he advises that the more you do it, the more streamlined the discussions become. “I’ve had lots of practice,” he says.
At the College of Pharmacy, Falk encourages students to be curious and question the status quo. Seeing them grow into thoughtful, innovative practitioners, he says, is one of the most rewarding parts of his career.
“Watching them take these ideas into their own careers and make an impact is incredible.”
Falk credits his own time as a UM student for sparking his drive to ask hard questions. “This is where I learned to challenge what we think we know,” he says. “It’s also where I realized that asking the right questions can lead to real change.
“Pharmacy practice is about thinking critically and challenging assumptions that don’t serve patients.”
BY ANNETTE ELVERS