Q and A with the experts: Pharmacists to prescribe for minor ailments

April 11, 2022 New proposed regulations in Ontario will allow pharmacists to prescribe medication  By New proposed regulations in Ontario will allow pharmacists to prescribe medication for 12 minor ailments. These proposed regulations have a public consultation window of 10 days before proceeding to cabinet for final approval.

Nardine Nakhla is a pharmacist and professor at the University of Waterloo and served as a member of an advisory group that provided input on the regulations. Nakhla explains what this change means for Ontarians.

What conditions will pharmacists be able to prescribe for?

A minor ailment is a health condition that patients can reliably self-diagnose and that can be managed with self-care strategies or minimal treatment, which can include prescription medication. The proposed regulation change will allow pharmacists to prescribe for the following conditions:

When will these changes come into effect?

The proposal is still under consideration, and we don’t yet know exactly when pharmacists will be able to provide these services. If the final approval happens quickly, the changes may come into effect as early as July 1, 2022. If approval takes longer, the implementation date may be pushed to January 1, 2023.

Aren’t pharmacists already providing advice?

Pharmacists have a long history of assisting patients with minor ailments, assessing them and often recommending non-prescription therapies for their management, facilitating other self-care decisions, and/or referring patients to other health care providers when warranted.

While self-care therapies can effectively manage certain conditions, some ailments may require prescription drugs for effective treatment. Under the new regulations, pharmacists will be able to prescribe these drugs.

Why allow pharmacists to prescribe for these conditions?

Currently, patients with a minor ailment who require prescription therapy must visit their doctor, walk-in clinic, or a local hospital. Often, patients wait days for an appointment or end up visiting a walk-in clinic or emergency department. Allowing pharmacists to provide support for these patients will improve healthcare system efficiency and the patient experience.

In Ontario, more than 95 per cent of patients live within five kilometers of a community pharmacist. They are accessible and knowledgeable; this scope expansion represents just one more way they can continue to support their patients, particularly outside the traditional nine-to-five business hours of many medical offices. P harmacists also serve patients in many other practice settings, from hospitals to long-term care facilities, to family health teams and more, where this scope expansion will have an impact.

Do other places allow for prescribing by pharmacists?

Prescribing for minor ailments is already part of the services pharmacists can provide in eight other Canadian provinces. Pharmacists in the United Kingdom have been prescribing since 2003. In addition to alleviating pressure from doctor’s offices, walk-in-clinics and hospital emergency rooms, research from the University of Waterloo suggests that providing this type of service may save the province upwards of $42 million annually. 

What training do pharmacists have to prepare them for offering this service?

Patient assessment and management of minor ailments are an integral component of our PharmD curriculum. Pharmacy students receive extensive training in this area and are experts in medication therapy upon graduation, equipped with the necessary competencies to support clinical decision-making required for minor ailment prescribing services. Furthermore, continuing education for minor ailment assessment and prescribing has been available and continues to be accessible to the profession to support preparation for this expanded scope.

As with any other practice development, pharmacists are responsible for assessing their need for additional continuing education to ensure they have the required knowledge, skill, and judgment required to provide quality patient care.

Why implement this change now?

The current pandemic has highlighted the need to consider multifaceted and sustainable solutions for health care and has brought to light health inequities and disparities. Pharmacists supported Ontarians throughout the pandemic, which has reinforced their role and commitment to accessible health care. Minor ailment prescribing services offer yet another opportunity for pharmacists to provide streamlined care pathways for Ontarians and optimize their therapy, thereby making health care more accessible and efficient in our province.

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