WELLINGTON COUNTY – Like a New Year’s resolution, expanded prescribing power for pharmacists was ushered in on Jan. 1 with early excitement and optimism.
Ontario health minister Sylvia Jones touted the move allowing pharmacists to prescribe for 13 minor conditions, such as pink eye and eczema, as a way to address the province’s strained health care system and issues accessing care.
Last month, the province expanded the list, adding six additional minor conditions that pharmacists can prescribe certain medications for, including:
- acne;
- canker sores;
- diaper rash;
- yeast infections;
- parasitic worm; and
- nausea and vomiting during pregnancy.
According to the Ontario College of Pharmacists, the profession’s regulating body, the six conditions formed part of a list of 19 total conditions originally recommended to the province, and were again submitted in March as proposed regulatory amendments.
According to the provincial government, 402,533 prescriptions have been written under the program with 4,453 pharmacies participating — over 80 per cent of all pharmacies across the province.
Some local pharmacists, however, say they are underwhelmed by the uptake experienced in the past 10 months, and wish there was more being done to spread awareness.
Fergus Pharmacy and Compounding Centre owner Deep Shah said fewer than 50 prescriptions have been written at his location since January.
He doesn’t believe the additional six conditions will do much to change that.
Centre Wellington Remedys Rx owner Rachel Luther declined to say how many prescriptions she has written, but thought she would be busier with the expanded scope.
Pharmasave Mount Forest Pharmacy owner Ravi Halani said he has written less than 100, far fewer than he thought he would.
Pharmasave Drayton Pharmacy owner John Walsh said only a handful of people are accessing what’s known as the minor ailments program each day.
Walsh is taking it upon himself to put on talks to spread the word locally.
But for those who do know what pharmacists can do, he said they seem to be happy to have another way to access care.
Erin Pharmacy owner Peter Meleka — an exception to the sentiment about people being unaware — said uptake has been great, with customers choosing the pharmacy to avoid lengthy waits and get faster treatment.
Meleka said more than 100 prescriptions have been written at his location since January.
Ontario Pharmacist Association CEO Justin Bates told the Advertiser in a phone call that Ontario continues to lag behind other provinces, such as Alberta, where pharmacists can prescribe for anything which isn’t a narcotic or controlled substance.
“I think from all accounts, we can say … this has been a successful program that’s been done safely and effectively,” Bates said, calling it a “tremendous success.”
Pharmacists’ education and skills remain underutilized in the province, he said, adding any new prescribing powers are welcome.
Not all are on board, however, including the Ontario Medical Association (OMA), a member-based organization representing the interests of Ontario physicians.
In a statement emailed to the Advertiser, the OMA suggested that allowing pharmacists to prescribe medications for “ailments self-diagnosed by patients” is “fragmenting an already fractured health care system.”
“This is not the correct approach, and will ultimately result in lower quality care with worse outcomes for all,” the OMA contended in its statement.
The association is calling on the province to keep the scope of physicians and other health care workers separate.
Bates countered that prescribing isn’t done in isolation; information is shared with family physicians, and safeguards are built into the patient assessment.
“There’s zero merit,” he said of the concerns, suggesting it all comes down to public money, and how it’s divvied up.
“To suggest that there’s any safety risk or that this not a good thing for the health care system I think misses the point, and it’s disappointing.”
Local pharmacists expressed a keen desire to help provide relief to a stressed system, and are supportive of a phased approach.
The expanded scope will help pharmacists ease the burden on the system, improve access to local care, and support better patient outcomes, said Walsh.
“I think Ontario’s just falling in line with other provinces,” he said.
“I think we’re doing it the right way.”
“In general, we are hungry for an expanded scope and the ability to help patients,” said Luther.
“We did a lot of this type of triage in the aisles anyway.”
The province is currently considering allowing pharmacists to prescribe birth control, and drugs for 16 conditions such as erectile dysfunction and shingles, all recommended in September by an Ontario College of Pharmacists advisory group.
Bates said pharmacists are “contributing a solution, and it’s giving people more options.”
He anticipates additional conditions will be brought in next year, with the potential for 36 total conditions for which pharmacists could prescribe.
The Ontario College of Family Physicians (OCFP), which represents 12,500 family doctors in the province, and describes itself as the “voice of family medicine,” did not provide comment for this story by deadline.
The OCFP has been critical of the expanded scope for pharmacists and has called on the pharmacists’ college to exercise caution.
