With more than 200 community pharmacies throughout Newfoundland and Labrador, many of them in small rural communities that lack medical clinics, pharmacists are well-positioned to provide accessible patient care and, with appropriate government support and funding, could increase access to health care for patients without family physicians.
Just one example of this is in the area of minor ailments. In 2015, new regulations under the Pharmacy Act allowed pharmacists in Newfoundland and Labrador to prescribe and treat a number of minor ailments requiring prescription medication, such as nausea, cold sores, hemorrhoids and eczema.
Studies have shown that these types of minor conditions may comprise up to 40 per cent of family physician office visits. And while it was positive when pharmacists were given the authority to prescribe and treat these conditions, more residents would avail of these services through their pharmacy if they did not have to pay out of pocket for it. Patients should be able to receive care from pharmacists without having to worry about the cost. Medical coverage for pharmacist care would certainly increase the number of patients availing of their local pharmacy instead of waiting to see a physician or going to the emergency room.
Government support for changes to pharmacists’ scope of practice, enabling pharmacists to practice to their full scope, would also increase the accessibility of health-care delivery at a lower cost.
With the infrastructure for these services already in place, we need to ensure our pharmacists are able to make use of their full scope of skills, improving patient outcomes and, as a result, creating savings for the public purse.
One example of this is urinary tract infections (UTI) — a common condition that often results in the initiation of anti-bacterial therapy. UTI is the eighth most common reason for ambulatory clinic visits and the fifth most common reason for emergency department visits in Canada. UTI affects 12 to 15 per cent of women annually and approximately 50 per cent of women will experience a UTI by the time they turn 32 years of age. The ability for pharmacists to prescribe for UTI varies in Canada from province to province, with New Brunswick, Quebec, Saskatchewan and Alberta all allowing pharmacists to prescribe for this indication, to varying extents.
Pharmacists are accessible primary care professionals who are well-positioned to take on a larger role in the management of UTI. Residents in this province suffering from uncomplicated UTIs should be able to get prescriptions directly from a pharmacist instead of having to visit their doctor, walk-in clinic or emergency room.
Another area where pharmacists could provide more accessible and cost-effective care is hypertension management. A 2017 study showed that comprehensive long-term pharmacist care, including patient education and prescribing for Newfoundland and Labrador residents with hypertension, not only improves health outcomes but will save money for the province’s health-care system.
The study supported the need for pharmacists to practice to full scope in the area of hypertension care. With the large number of people living with hypertension in this province, the burden on society is enormous, both in health and economic terms. Pharmacists are highly accessible primary health-care providers and ideally positioned to address the care gap in hypertension management. With the infrastructure for these services already in place, we need to ensure our pharmacists are able to make use of their full scope of skills, improving patient outcomes and, as a result, creating savings for the public purse.
PANL believes collaboration is key to creating a more sustainable health system and looks forward to working with government, physicians and other health-care providers to improve access to health-care services, particularly in areas without readily available physician services.
Janice Audeau, community pharmacist
President, Pharmacists’ Association of Newfoundland and Labrador
