Many think of community pharmacists as the healthcare providers who dispense prescriptions and offer patients professional advice on their best use. But in recent years the pharmacist’s role has expanded so they can be more involved in patient care.
Across Canadian jurisdictions community pharmacists can now provide emergency prescription refills and renew and adapt prescriptions in nine provinces and one territory, prescribe for minor ailments in six provinces and initiate prescription drug therapy in seven provinces, among other expansions to scope of practice.
In Ontario, pharmacist prescribing authority is somewhat more limited as they can prescribe only smoking-cessation medications and adapt and renew existing prescriptions.
“Ontario’s primary-care providers have a lot on their plates caring for patients with a wide range of conditions, some more acute or complex than others,” said Dr. Lisa McCarthy, lead of OPEN’s Pharmacist prescribing project and an Assistant Professor at the University of Toronto’s Leslie Dan Faculty of Pharmacy.
“For example, patients seeking care for a minor ailment, like a cold sore, puts pressure on already stretched clinics and emergency rooms. In other provinces, pharmacists are helping to address this through prescriptive authority. Our team is looking at what we can learn from other jurisdictions’ experiences to develop a made-in-Ontario approach.”
Opening a dialogue
To this end, Dr. McCarthy and her team have been working with the McMaster Health Forum — a hub for improving health outcomes through collective problem solving — to gain perspectives and insights of stakeholders and citizens on pharmacist prescribing.
“We are interested in views about models in other Canadian provinces, like those in Quebec, Saskatchewan, Nova Scotia and Alberta,” Dr. McCarthy said. “Stakeholder dialogues can increase the use of evidence in policy making.”
Evidence brief to catalyze debate and problem solving
Dr. McCarthy, along with Dr. François-Pierre Gauvin, Scientific Lead, Evidence Synthesis and Francophone Outreach, McMaster Health Forum and Dr. John Lavis, Director, McMaster Health Forum, and Professor, McMaster University, prepared an evidence brief to catalyze debate with stakeholders and start collective problem solving about the preferred policy option identified through consensus.
The dialogue with policy and practice stakeholders was held on June 16, 2015.
Continuing the dialogue with patients
Dr. McCarthy’s team worked with the McMaster Health Forum again to convene another dialogue, this time with citizens who had the opportunity to voice their views on pharmacist prescribing.
“The results of these dialogues will allow for a better understanding of pharmacist prescribing from two pivotal stakeholders — knowledge users and patients,” Dr. McCarthy said.
“Our hope is that these dialogues will inform discussions with provincial policy makers about the next steps for pharmacist prescribing in Ontario.”
Publications from the McMaster Health Forum
Exploring models for pharmacist prescribing in primary and community care settings in Ontario