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Pharmacies can be safe space for victims of domestic violence

Quebec pharmacist co-authors guidelines to help pharmacy staff identify and support patients of domestic abuse.

Pharmacists are not always aware of the fact that they can become allies of victims of domestic violence.

Simon Matoori, a professor at the Faculty of Pharmacy of the University of Montreal, co-authored guidelines on the subject to help his fellow pharmacists offer support.

Given that pharmacy staff have access to a great deal of information about their patients—medical and personal—they can more easily identify victims of abuse, says Matoori. In addition, “there is a bond of trust and closeness that unites patients to their pharmacist,” making pharmacies safe places. “As you can buy basic necessities there, [pharmacies] are accessible to victims, whose movements are otherwise controlled by their abusers.”

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Since the pandemic, thanks to Matoori’s leadership, Proxim and Uniprix banner stores have stepped up to raise awareness by displaying a purple sticker on their front doors indicating to victims that they have a secure space to seek help.

He regrets that the banners don’t specify that pharmacists can also offer psychological support. “We are trained to assist people who express suicidal thoughts, so we can also support victims of domestic violence,” he says, noting that this skill should be taught to pharmacy students as well as professionals as part of standard training.

In the meantime, the professor has co-authored a practical guide with a psycho-educator, psychologist and a sexologist from Montreal. These guidelines, recently published in the Canadian Pharmacists Journal, provide advice on how to intervene skillfully with victims at different levels.

The guide provides information on the various signals that can characterize a person confronted with domestic violence. “There are typically associated injuries, such as hematomas and fractures to the face, often in the nose area,” he says. “We also see ulnar fractures caused when the victim tries to protect himself from the blows. On a psychological level, depression or anxiety can also be symptoms.”

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When a professional spots such signs, they should attempt to engage in conversation by asking open-ended questions. “Often, we realize that the patient's story does not hold water,” says Matoori, who then recommends examining the person’s pharmaceutical file. Anti-inflammatories, anxiolytics or antidepressants, as well as non-ideal adherence to treatments, should raise suspicion.

If the person lives in a poor neighborhood, this can be another signal, “because the literature shows that this is an important factor,” says the professor. “All of this information put together constitutes a bundle of clues.”

In such circumstances, the pharmacist must show empathy “without judging the person or telling them what to do or not to do, as their abusers do,” he says. “We shouldn’t pressure them either. When victims disclose their situation, they do not leave their partner immediately. They can try it six or seven times before they succeed.”

Obviously, these conversations should not be held at the counter, in front of everyone, but in a private space where the victim will feel more comfortable. Beforehand, the pharmacist will find out about local resources (contact information organizations that can help, shelters, etc.). And, at the end of the discussion, “we must reassure her by telling her that she can count on our support, that she can come back if she does not feel safe or call if necessary,” recommends Matoori.

Currently available in English, the guidelines on the care of victims of domestic violence in pharmacies are being translated into French. This June, the authors will also organize an evening of free training on the subject for pharmacists in Quebec at the University of Montreal.

This article has been translated from its original French and originally appeared on our sister site Profession Santé.

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