Looking to get healthier faster? In Ontario, starting on January 1, 2023, you can skip making a doctor’s appointment and instead drop by your local pharmacy if you need a prescription medication to treat one of 13 minor ailments. This brings Ontario in line with all other provinces and territories except British Columbia (pending), Nunavut and the Northwest Territories.1
Even in jurisdictions where they can’t yet prescribe, pharmacists are highly trained professionals with specialized expertise that can help people get better more quickly. With the fast pace of advancements in pharmacological treatments, it’s time for Canadians to consider including an accessible, knowledgeable pharmacist as an integral part of their healthcare team.
How has Ontario expanded pharmacists’ role?
The Ontario government now allows pharmacists to prescribe medications for hay fever, oral thrush, pink eye, dermatitis, menstrual cramps, acid reflux, hemorrhoids, cold sores, impetigo, insect bites and hives, tick bites, sprains and strains, and urinary tract infections. Because pharmacists cannot make a diagnosis, the strategy is limited to health conditions “that can be reliably self-diagnosed and managed with self-care strategies and/or minimal treatment.”2
The big win for patients is that pharmacies are located in most communities across Ontario (and Canada), so expanding pharmacists’ scope of practice also expands access to healthcare into rural and remote parts of the province (and country) – and, of course, having access to medical care is a cornerstone of healthy living. Also important, this will free up doctors’ time, enabling them to focus on providing care for more complex needs and hopefully reducing wait times in primary care settings, walk-in clinics and emergency departments.
There’s even an argument to be made that allowing pharmacists to prescribe may improve patient safety by reducing medication errors compared with doctors’ often paper-based systems.
What else can pharmacists do?
An overview of community pharmacists’ role in Canada found that they’ve established a very strong presence in our lives, with 55% of Canadians reporting that they visit a pharmacy weekly and see a pharmacist up to 10 times as often as they see their family doctor. The same study reported that pharmacists rank consistently near the top of “most trusted” lists of health professionals.3
There’s no question pharmacists play an essential role in Canada’s healthcare system, responsible for the safe and effective dispensation of about 750 million prescriptions every year.4 The Canadian Pharmacists Association describes pharmacists as “the medication management experts” within a healthcare team.5 As a result, they must have a deep understanding of all the drugs they dispense, including contraindications and interactions with other drugs. They must also be able to detect any improper use of medications, such as overdoses or misuse, and take appropriate action.
That said, pharmacists in every province regularly do much more than dispense medications. And, while there are provincial differences when it comes to a pharmacist’s scope of practice, some of the specialized services most are able to offer can significantly improve patient outcomes. Here are just a few of the “extras” a pharmacist can deliver.
Education about prescription medications
Pharmacists can provide advice on the prescriptions they fill, alerting patients to possible side effects and drawing their attention to the recommended dose amount and schedule. All of this makes it more likely people will take their medication as prescribed, avoiding the health risks associated with medication non-adherence.
Education about over-the-counter treatments
While pharmacists cannot diagnose illnesses, they can recommend over-the-counter treatments that may provide symptom relief for people with colds, coughs, sore throats, allergies, headaches, muscle pain, indigestion, skin rashes and other mild infections. And they can always refer to a doctor if they believe a patient’s symptoms require further investigation.
Medication therapy reviews
Pharmacists can conduct one-on-one medication therapy reviews, which are critically important for people taking more than one prescription drug, or mixing prescribed drugs, over-the-counter drugs, and natural health products. If pharmacists have therapeutic concerns, they will recommend a solution that resolves the problem – which may include consulting with the patient’s doctor. For employers, a medication therapy review can reduce the risk of adverse reactions to drugs, improve medication adherence, and ensure employees are taking the most cost-effective drug for their condition.
Opioids (narcotics) in particular can be misused and have been leading to an increasing number of hospitalizations and deaths. Pharmacists are best positioned to educate patients about how to use, store and dispose of medications and explain how dangerous it can be to use any medication except as prescribed. They may also notice red flags that suggest medication abuse, such as prescription refills happening too frequently, and can alert a patient’s doctor if they have concerns. Pharmacists can also support treatment with methadone (a long-acting opioid used to replace shorter-acting opioids someone may have an addiction to), providing education, supporting adherence, and dispensing daily drinks or weekly “carries.”
Pharmacists can offer a range of wellness services that keep people healthier and improve quality of life and productivity at work. They may, for example, suggest nutritional supplements, provide smoking cessation counselling, administer vaccines and offer pre-travel consultation. By providing accessible health management education and support, they can complement wellness programs in the workplace, amplifying the effects of those initiatives.
How can pharmacists help with non-pharmacological interventions?
Working with a pharmacist to integrate non-pharmacological interventions into a treatment plan can help people with chronic conditions and those with multiple health concerns manage their health more effectively.
In general, medication can provide relief from pain, control symptoms and reduce the risk of further health complications – though it is, of course, important to consider side effects and interactions with either other medications or supplements. However, a well-rounded treatment plan should also include interventions such as physical activity, stress management techniques, lifestyle modifications and psychosocial support.
- Regular physical activity can improve physical functioning and reduce pain levels for many chronic conditions. It also helps maintain bone density and muscle strengths, lower blood pressure and cholesterol levels, reduce stress levels, improve sleep patterns, and increase energy levels.
- Stress management techniques, such as relaxation exercises, mindfulness practices, positive self-talk/affirmations, journaling and art therapy, can help alleviate feelings of anxiety associated with managing a chronic condition.
- Lifestyle modifications, such as dietary changes (e.g., reducing the consumption of processed foods or increasing the consumption of vegetables) may also be beneficial. Certain dietary changes, for example, have been linked to improved blood sugar control for individuals with diabetes or lowered cholesterol for individuals with heart disease.
- Psychosocial support through referrals to healthcare professionals such as counselors and social workers can be invaluable in helping patients feel supported while navigating their medical condition(s).
Pharmacists are in an ideal place to discuss ways to build on the positive effects of medications with non-pharmacological interventions. They can also keep an eye out for symptoms (for example, weakness) that might indicate an unaddressed issue (for example, hypoglycemia) and work with a doctor to address the situation. As always, it’s important for patients to discuss any questions or concerns about their treatment plans with their healthcare providers so they can make informed decisions about their care options moving forward.
How is the pharmacist’s role changing?
During the pandemic, pharmacists really came into their own in the minds of many Canadians when they became a preferred source of medical guidance. In fact, in one survey,6 nearly three in four pharmacists (72.2%) agreed with a statement that suggested people were visiting pharmacies in the early days of COVID-19 specifically to avoid the risk of getting sick while visiting an ER or doctor’s office. A number of other studies over the past couple of years have reinforced the idea that the pandemic served as a catalyst, making pharmacists’ capacities more visible to the general public.
Pharmacists’ role continues to evolve as new technologies are developed for drug delivery systems – such as automated pill dispensers and telepharmacy apps. Automated pill dispensers can release preloaded doses of multiple medications at customized intervals, alerting patients that it’s time to take their pills. pharmacy apps, such as TELUS Health Virtual Pharmacy, provide people with private, convenient, online access to pharmacists, as well as tools to manage prescriptions and track delivery to their homes.
Another big shift is an increasing emphasis on providing proactive support for patient health outcomes, rather than simply reactive treatment after a problem has already occurred. This includes developing disease management programs and helping patients access resources related to their conditions, including support groups, and offering guidance on sustainable lifestyle changes that can help them keep their illness under control.
Overall, pharmacists are key players in the advancement of Canada’s healthcare system. Ensuring the safe and effective use of medications is central to their role but, more and more, so is providing direct patient care through counselling and additional services that can help prevent future health challenges.
Why invite a pharmacist to join your healthcare team?
Healthcare is becoming increasingly complex. With a growing number of specialists, medications and treatments available, it can be difficult for people to navigate the ever-evolving landscape of healthcare on their own. With a pharmacist on your healthcare team – ideally working collaboratively with others such as doctors and nurses whom you already count on – you have a highly trained professional with a unique skill set to consult about:
- How to take and store medications properly, so you can minimize potential side effects and adverse reactions
- How a newly prescribed medication may interact with previous prescriptions and whether you may want to opt for another similar drug instead
- How supplements and other over-the-counter treatments may interact with prescribed medications and what’s safe for you to take
Checking in with a pharmacist on a regular basis can be especially beneficial for people with chronic conditions that require multiple long-term prescriptions. In all Canadian jurisdictions except the Nunavut and the Northwest Territories, pharmacists can closely monitor medication regimens and adjust doses if necessary to keep symptoms under control. They can suggest non-prescription options such as vitamins that may help as well. And, based on their experience with similar patients, they can offer personalized advice and develop tailored treatment plans that may work better than generic solutions prescribed by other healthcare providers.
Best of all, it’s easy to get a pharmacist’s expertise working for you. As already mentioned, pharmacists are among the most accessible healthcare providers. In 2022, 44,031 licensed pharmacists were practising at 11,814 licensed pharmacies across the country – and the vast majority of those pharmacies (11,356) are community pharmacies rather than in-patient hospital pharmacies.7 That means pharmacists are available to patients outside the major centres where a doctor, clinic or hospital may be far away and public transportation is limited.
While not everyone has a primary care doctor, almost everyone has access to a local pharmacy. Furthermore, there are no barriers like having to make an appointment – people can walk into a pharmacy anytime during opening hours. That means you (or your employees!) can get quick advice when needed and get on the path to recovery faster.