Ask Your Pharmacist

March 29, 2019
Q:

What can pharmacists prescribe? Is it different in every province? 

A:

Pharmacists are the medication experts. Managing medications - and sometime prescribing - are typically part of the job description. The level to which pharmacists can prescribe does vary by province, and I’m proud to say that New Brunswick pharmacists are on the forefront when it comes to prescribing.

Most people are familiar with pharmacists prescribing to continue medications for long-term conditions. If you’ve run out of refills on a medication you use regularly and are unable to see your doctor for two weeks, your pharmacist can make an assessment and, if appropriate, extend the prescription for that medication to get you through until your next appointment. Pharmacists can also prescribe in emergency situations such as if you’ve lost medication or run out of medication on vacation. In these situations, your pharmacist is prescribing to continue to medication and as a general rule, will not be changing medication regimens.

Interestingly in Alberta, pharmacists have taken monitoring long-term conditions to the next level. Pharmacists are monitoring patients’ blood pressure and are prescribing medications and making medication changes as appropriate. This practice has been studied in Alberta, and the studies have shown that on average, blood pressure is lower in patients monitored by pharmacists. A 2017 study found that comprehensive long-term pharmacist care for New Brunswickers with hypertension, including patient education and prescribing, would improve health outcomes and save money for the province’s cash-strapped health care system. Projected cost savings would be more than $445 million if full scope pharmacist care were administered to the full eligible population in New Brunswick.

New Brunswick is a national leader when it comes to pharmacists independently assessing and prescribing for minor ailments. Since 2014, New Brunswick pharmacists have had the authority to assess, treat and if appropriate, prescribe for 32 minor ailments such as cold sores, uncomplicated urinary tract infections (UTIs), yeast infections, allergies and, eczema. This allows New Brunswickers to take advantage of the accessibility of pharmacists, saves hours of waiting at outpatients’ clinics or emergency rooms. UTIs are a great example. UTIs predominantly cause burning and painful urination and a feeling of urgency. This can be very uncomfortable and leaves patients seeking urgent treatment which is a short course of antibiotics. New Brunswick pharmacists can assess symptoms, determine if the symptoms are consistent with an uncomplicated UTI, and prescribe a medication if appropriate based on these symptoms (as long as they have ruled out complicating factors and contraindications). Last June, eyes were on New Brunswick as a groundbreaking study found that patients with uncomplicated urinary tract infections can access effective and fast treatment from pharmacists.  The study, conducted in New Brunswick, also demonstrated that patients got treatment one to two days quicker. Urinary tract infections are among the top ten reasons for ambulatory clinic visits and in the top five reasons for emergency department visits in Canada. Although New Brunswick pharmacists are able to prescribe for uncomplicated urinary tract infections, the service is not funded by Medicare, forcing patients to pay out pocket.

It will be interesting what happens over the next decade when it comes to pharmacists prescribing. Saskatchewan pharmacists are funded by government to treat UTIs, and they have recently added conditions like erectile dysfunction and contraception (birth control) to the list of minor ailments that pharmacists can treat, while in other provinces pharmacists are using point-of-care testing to diagnose strep throat. Who knows what is in the future for New Brunswick, but I know patient health and safety will always be priority number one.

Check out www.nbpharma.ca for a complete list of minor ailments and information on what pharmacists can do to help you stay healthy. Of course, you can always ask your community pharmacist too!

Jared Mactavish (BSc., Pharm) is a pharmacist in Saint John. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.