One element of pharmacy practice has long been assessment of medication needs. Last January, Ontario pharmacists were authorized to take this one step further: based on the patient’s presentation and need, pharmacists are now authorized to prescribe medication when it is indicated for treatment of 13 minor ailments. As of April, 82% of Ontario’s community pharmacies were delivering this element of healthcare.
But this scope expansion is not the first. As we all know, the stress on the healthcare system has been building for many years and authorized pharmacy practice has evolved in response. Prior to 2012 pharmacists didn’t have the authority to renew and adapt prescriptions, for example. Other stages in the evolution were the authorizations to administer select vaccines and perform certain point-of-care tests. Pharmacy technicians were later authorized to provide influenza vaccines.
In the last few years in particular, we’ve seen rapid temporary scope expansions in response to pandemic-generated need including COVID-19 vaccine administration, Paxlovid prescribing and authorizations to renew and adapt controlled drugs and substances.
Always, the purpose of these changes is to get patients the quality care they need as quickly and efficiently as possible. And we can measure the impact of pharmacy in this regard in concrete terms: between January and April, patients chose to go to community pharmacies for consultation on 182,932 minor ailments and pharmacists issued 151,210 prescriptions. Sometimes the patients were sent to see their primary care providers for follow-up or further assessment, but we may assume that many of these assessments replaced primary care or emergency visits. That is a win for patients and the healthcare system.
The need has not gone away, though, and more change is coming.
As of July 1, 2023, for purposes other than patient demonstration and education, pharmacists will be authorized to administer by injection and inhalation substances listed in regulation. And the College has recently submitted proposed regulatory amendments to add the authority to prescribe for six additional minor ailments.
So, what comes next in this evolution? In response to a request from the Minister of Health, the College is exploring additional scope expansion, starting with more minor ailments. We have convened an expert advisory group made up of pharmacists, physicians, and researchers. This group will consider a range of possibilities, undertake and direct appropriate research, and provide recommendations to the Board about what additional activities pharmacists could safely offer and what educational, regulatory or other considerations might be required.
Expert advice is great, but that’s not self-regulation. We will need YOUR input so that the Board can make decisions that reflect your expectations for the profession you practice.
As this work progresses, we will keep you informed and seek your opinion. Because you know the realities of your work environment, the knowledge, skills and judgment of your colleagues, the value of supplemental training and testing, and what your patients need from you.
Your job, like ours at the College, is to ensure the delivery of safe and effective pharmacy care. Sometimes that happens in the pharmacy and sometimes it happens at the regulatory level. I look forward to partnering with you on these important next steps.