Pharmacists now prescribe drugs for minor ailments

The BC College of Pharmacists says three-quarters of the 4,200 community-based pharmacists have completed a 40-minute online training that enables them to prescribe medications for 21 minor ailments.

BC pharmacists began diagnosing and prescribing medicines for minor ailments Thursday under an expanded scope of practice aimed at helping those without family doctors and reducing pressure on the healthcare system.

The BC College of Pharmacists said three-quarters of the 4,200 community-based pharmacists have completed a 40-minute online training that enables them to prescribe medications for 21 minor ailments, from acne to urinary tract infections, as well as birth control. . It’s a step that other provinces, including Ontario and Alberta, have already taken.

Previously, in BC, all prescriptions had to come from a doctor or nurse practitioner. Last October, the province allowed pharmacists to temporarily administer vaccines and renew prescriptions for two years, for patients whose family doctors had retired or stopped practicing.

Now patients who do not have a family doctor or cannot see their doctor in a timely manner can make an appointment online starting June 29, in a system similar to that established for COVID vaccines, or go to a pharmacy for a prescription for any of 21 ailments.

Health Minister Adrian Dix said this week that the new services will free up doctors and nurses to focus on patients with more complex needs.

The government estimates that more than 750,000 patients will use the services in the first year.

Victoria’s pharmacist, Kimberley Myers, of Shoppers Drug Mart on Fort Street, had yet to prescribe a drug as of Thursday afternoon and doubts the lawsuit will be immediate. “It’s not a crazy race by any means,” Myers said. “We will just treat, as needed, people with conjunctivitis or allergies; We’ll treat it as it comes.”

Some of the other conditions that pharmacists may prescribe medications include yeast infections, acid reflux, hemorrhoids, cold sores, impetigo, shingles, and vaginal yeast infections.

Myers says it’s not much different, in terms of workload, from what pharmacists already do when recommending over-the-counter drugs. She imagines the most common request will be from someone running low on birth control or allergy medication, for example.

“He has access to pharmacies much faster than he could get to the emergency or possibly see his doctor.”

Pharmacists will follow up with patients with a phone call and ask them to return to the pharmacy.

‘Collaborative approach’

A complicated case would be referred to a doctor, urgent care center, or emergency department. “It’s a collaborative approach,” Meyers said.

“We are working in conjunction with primary care physicians and the health care system. … I think it also takes a huge load off our ERs and on a health care system that is already overwhelmed by things that are common or more simple.”

It is estimated that close to one million British Columbians do not have a family doctor.

Dr. Joshua Greggain, president of Victoria-based Doctors of BC, said he is hopeful that the expanded scope of practice for pharmacists will be effective. “But we also want to make sure that we continue to work with pharmacists and the government, as it hasn’t always been the case when we do new and creative things.”

While the association recognizes that pharmacists are the experts in medicines and pharmaceuticals, it says that doctors’ main concerns are patient safety, ensuring that pharmacists are accountable for their diagnoses and prescriptions, and a communication system that in some cases still depend on fax machines.

“We still have an isolated health care system where [electronic] the information to date is not communicated to each other, so now we have a new team member,” said Greggain. Making sure the information is provided to doctors and specialists, if the patient has one, is important, he said.

All drugs dispensed in BC are recorded in the PharmaNet system.

“In an ideal world, we would all be able to access the same information at any time,” Greggain said. “As of June 1, 2023, there’s no integrated system and so I think we’re going to have to rely on older technology that’s out there a lot right now, which includes faxes and e-faxes and that kind of information. , until we can hopefully get to a place where that information is kept centralized.”

Greggain said that in terms of patient safety, everyone in the health care system knows that any medication carries risks, and that any one of 21 conditions could be a sign of a much more serious disease.

“Inevitably, there will be some challenges, some side effects or some consequences,” Greggain said.

Doctors are most concerned about pharmacists prescribing for urinary tract infections or bladder infections without laboratory tests and a medical history that could determine which antibiotic will be most effective or help make an accurate diagnosis, Greggain said. Abdominal pain that presents as a urinary tract infection could also be something more serious, such as a kidney infection, ectopic pregnancy, or bladder stones.

Faster path for patients

Suzanne Solven, registrar for the BC College of Pharmacists, said there will likely be more patients, mostly women, who will benefit from being able to quickly access medication to treat a urinary tract infection that, if left untreated, could spread to the kidneys

“What we are hearing from the experiences of the other provinces is that actually the ICU is where most of the patients were most eager to see the pharmacist,” Solven said. “I appreciate the concerns of the BC Doctors, but I would say that it is actually worse if the patient does not receive treatment.”

Solven said the pharmacists will perform a full assessment, ask the patient questions — which they do even when recommending over-the-counter medications — and ensure proper follow-up.

Solven said most healthcare providers can connect to PharmaNet, with some limitations, but he looks forward to “the day we have a system that provides the complete medical record.”

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