Ontario pharmacists seek expanded scope of practice
Ontario pharmacists seek expanded scope of practice
It’s Friday night and a mother needs help with her infant son who won’t stop crying. Her family doctor is out of the office until Monday. A visit to the local emergency room could result in a wait of several hours.
Stoney Creek, ON

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Queenstown Pharmacy, Stoney Creek, ON

Hamilton Community News, Stoney Creek ON

By Mike Pearson

It’s the kind of story Allan Austin has heard many times.

It’s Friday night and a mother needs help with her infant son who won’t stop crying. Her family doctor is out of the office until Monday. A visit to the local emergency room could result in a wait of several hours.

Austin, director of communications for the Neighbourhood Pharmacy Association of Canada (NPAC), said in some provinces, a pharmacist could directly prescribe medication for a minor ailment, such as diaper rash. So far, Ontario hasn’t joined that list of provinces, which currently includes Saskatchewan, Manitoba and Nova Scotia.

An NPAC report says expanding pharmacists’ scope of practice to include treating minor ailments and administering vaccines could prevent up to 600,000 ER visits; 1,500 hospitalizations and free up 2.4 million physician hours to focus on more critical care.

“It’s about enabling neighbourhood pharmacists like this one to do things like diabetes education,” said Austin. “If pharmacists had expanded scope of practice to do things like prescribing for minor ailments, you then get the mom and the baby taken care of at one time, one place.”

Ashraf Zaki, pharmacist manager inside the busy Queenston Medical and Dental Centre, said increasing a pharmacy’s range of services can help relieve pressure on the overall health care system.

“I consider pharmacists the most accessible health care providers,” he said.

An appointment with a family doctor can involve a lengthy wait time, especially if patients don’t have an appointment, Zaki said. Nurses often have the same medical expertise as doctors, but aren’t easily accessible.

Zaki said Queenston Pharmacy welcomes an expanded scope of practice. The pharmacy already provides blood glucose testing for diabetes patients. Like other pharmacies throughout Ontario, Queenston Pharmacy can administer flu vaccines, but typically refers patients to one of the family doctors located within the same building.

Kathryn Clarke, spokesperson for the College of Physicians and Surgeons of Ontario, said the college does in general support scope of practice expansions for other regulated health professionals – as long as those expansions meet certain standards.

Clarke said the changes must be consistent with the knowledge, skill and judgment of the professionals involved and those professionals must be subject to a rigorous regulatory structure. The expansion of scope must involve a collaborative approach to care, include educational initiatives for both the public and health care providers so that everyone understands the changes being made. And any changes must be safe for patients.

“The CPSO is of the view that stringent educational requirements must be put in place by regulatory colleges to ensure that all health professionals have the necessary knowledge, skill and judgment to effectively and safely prescribe the drugs designated in their respective regulations,” Clarke said.

But Dr. Ved Tandan, Ontario Medical Association president, stressed it’s important that patients are served by the most appropriate health professional.

“Ontario’s Doctors believe every health care professional has a role to play in providing the best quality of care to everyone in Ontario and that success comes from working in collaboration. Ontario’s doctors value pharmacists as key partners in providing excellent care to patients.  That being said, it is important to ensure that any health professional providing any service is deemed the most appropriate to ensure Ontario’s patients are receiving the best care.  In Ontario, a wide variety of medications for ‘minor ailments’ are already available over-the-counter and the OMA believes this strikes a good balance between access and safety,” Tandan states in an email.

Hamilton East-Stoney Creek NDP MPP Paul Miller said expanding a pharmacy’s range of services can alleviate the pressure on ERs and help patients deal with minor health concerns, instead of sitting in a doctors office for hours on end.

“I am in support of expanding the scope of practice at pharmacies,” said Miller. “I think it is going to take some pressure off the (health care) system. Certainly it can free up beds. It can help emergency rooms deal with more serious situations. People won’t go in to the hospital with a cut, they’ll go to the pharmacy.”

Miller said the NPAC could work in conjunction with the Ontario Medical Association to determine how pharmacies can offer expanded services. Miller said health care and education combined represent close to 70 per cent of provincial government expenditures and any effort to reduce those costs are welcomed.

Along with the ability to treat minor ailments and administer vaccines, the NPAC’s plan to improve access to affordable health care includes ensuring affordable access to key medications, providing the ability to manage chronic conditions, leveraging the pharmaceutical distribution model and preventing adverse drug reactions.

The NPAC report was independently validated by the Conference Board of Canada

Ontario pharmacists seek expanded scope of practice
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