Ontario pharmacists will be able to evaluate and prescribe drugs for minor ailments starting next year, but some are calling on the province to expand that list and make the changes sooner to ease some of the pressure on the health care system.
Justin Bates, CEO of the Ontario Pharmacists Association (OPA), says the changes are a good first step, but he would like to see more services added.
“We need to expand it. Ontario is taking a very cautious approach with only 13 conditions,” Bates told CBC News.
“There are provinces that allow pharmacists to prescribe all medications except narcotics and controlled substances.”
The Ford government is set to extend pharmacists’ scope of practice in January 2023. The list of 13 minor illnesses they will be able to prescribe medication for pink eye, urinary tract infections and allergic rashes. While pharmacists welcome the news, they say more can be done to add capacity to an already strained system.
From January 2023, pharmacists will be able to prescribe medicines for 13 minor ailments such as pink eye, urinary tract infections and allergic rashes. (Nathan Dennett/The Canadian Press)
Pharmacists have been testing for COVID-19 and administering vaccines since the start of the pandemic.
Kyro Maseh, a pharmacist at a pharmacy in Toronto’s east end, says that while he is happy to see the changes, they will start “too late.”
“We need it now,” Masse said.
“This should include other minor illnesses; we shouldn’t have to go through all this trouble just to give this patient something for their osteoporosis that could potentially prevent a fracture.”
The changes will apply under the following conditions:
- Allergic rhinitis.
- Candidal stomatitis (thrush in the mouth).
- Conjunctivitis (bacterial, allergic and viral).
- Dermatitis (atopic, eczema, allergic and contact).
- dysmenorrhea.
- Gastroesophageal reflux disease.
- Hemorrhoids.
- Labial herpes (canker sores).
- Impetigo.
- Insect bites and urticaria (hives).
- Tick bites, post-exposure prophylaxis to prevent Lyme disease.
- Musculoskeletal sprains and strains.
- Urinary tract infections.
All of the above are short-term illnesses that do not require laboratory results and are low-risk for treatment.
But Masse says antiviral treatment for shingles should be included.
“I see it, it’s in front of me and I can’t do anything about it,” he said.
He says the same is true for Paxlovid, an antiviral drug that is often prescribed for COVID-19 and requires a prescription. The OPA says pharmacists should also be able to prescribe it.
Justin Bates, CEO of the Ontario Pharmacists Association, says the new services should be publicly funded. (Submitted by Justin Bates)
Masse says that because it must be administered within the first five days of the onset of COVID-19 symptoms, having to get a doctor’s prescription for Paxlovid wastes valuable time.
“It takes resources out of the system as a whole and we all suffer as a result.”
Another challenge is the lack of a unified electronic health record, Bates says, “so we don’t have the challenges of repeat hospital visits.”
Bates says the lack of unified records often leads to misunderstandings between hospitals and pharmacies. He says this can lead to errors that cause patients to be readmitted to hospital soon after being discharged.
Expanding services reduces emergency room visits, study shows
A University of Waterloo study appears to support Bates’ claims.
The study found that almost 35 percent of avoidable emergency room visits could be managed by pharmacists prescribing medications for common or minor health problems.
Pharmacists should be able to help fill these gaps in care, says Lisa Dolovic, dean of the University of Toronto’s Leslie Dunn School of Pharmacy. She says the research shows that when pharmacists are able to review prescriptions with patients, they can identify and resolve potential problems before they happen.
Lisa Dolovic, a pharmacist and dean of the University of Toronto’s Leslie Dann School of Pharmacy, says better use of pharmacists has been shown to reduce emergency room visits. (Paul Borkwood/CBC)
“If people have been discharged from hospital and they get a review done by their community pharmacist, it actually helps prevent them from being readmitted to the hospital in a short period of time,” Dolovic said.
“We have 17,000 pharmacists in Ontario, we have over 5,000 technicians, we have over 1,500 pharmacy students. So that’s quite a large number of people that we think can be part of the solution.”
Pharmacists are a ‘critical part’ of health care: province
The Ministry of Health confirmed to CBC News the regulatory changes that will allow pharmacists, students and interns in Ontario to prescribe drugs for listed diseases.
“Pharmacists, through their training and formal education, possess in-depth knowledge and strong clinical skills that are a critical part of the health care system,” a ministry spokesman said in a statement.
“The changes that have been made to pharmacists’ scope of practice will provide greater convenience and choice for patients to receive healthcare services.
But Bates warns that patients will have to pay for the services and says they should be publicly funded.
“Your socioeconomic status shouldn’t determine whether you can access services if we’re really going to add capacity and create more access across the system,” he said.
“We can’t avoid the realities that costs are going up everywhere, patients and the public and health care providers.”
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