Ask Your Pharmacist

December 16, 2021
Q:

I heard that pharmacists can now prescribe antibiotics for urinary tract infections?

A:

Since 2014, New Brunswick pharmacists have had the authority to perform assessments and where appropriate, prescribe medications for 32 minor ailments, including uncomplicated urinary tract infections.

Recently, however, the Government of New Brunswick announced that Medicare will cover the cost for pharmacists to assess and prescribe for uncomplicated UTIs. Previously, patients had to pay out of pocket (about $20-25) when they got treated by a pharmacist for UTIs. This meant that far too often those patients ended up waiting at an ER when they could be treated more efficiently by a pharmacist. Publicly funding this pharmacy service ensures all patients can access them and helps ease the burden on family physicians and ERs.

Urinary tract infections are the most common bacterial infections in women, with one-half of all women experiencing at least one in her life-time. Anyone who has had a UTI knows how urgently they need to seek treatment. Common symptoms of a urinary tract infection include painful urination, frequent voiding of small urine volumes, urgency to urinate, and tenderness just above the pubic area. Not all cases of UTI can be treated by a pharmacist. Pharmacists can assess and treat patients with the above symptoms between the ages of 16-64 born with the biological sex of female. Women of child-bearing age who have never been diagnosed with a urinary tract infection should be evaluated by a physician or nurse practitioner.

You must have a valid Medicare number to be eligible, and this service is not available to New Brunswickers who are residents of a long-term care facility. In general, pregnant women, men, or children require an assessment from a physician or nurse practitioner because urinary tract infections have the potential to be more complicated and likely require closer monitoring and follow-up.

If you meet all the eligibility requirements, a pharmacist will conduct your assessment, which must be done in person. Phone consultation is not an option. The pharmacist will review your basic demographic information, your allergy history and any antibiotics you may have had in the last three to six months. The pharmacist will also review your current medication regimen as well as a review of your other medical conditions. In your own words, you will tell the pharmacist what caused you to seek medical attention for this matter. The consultation takes approximately 15 minutes and occurs in a private counselling area. There is generally no need to dip the urine for this assessment because diagnosis of an uncomplicated infection is usually based on signs and symptoms.

The pharmacist will work with you to develop a plan to monitor resolution of the signs and symptoms. If a prescription is required, the pharmacist will inform you about what possible side effects of the medication may occur and how to manage them, as well as which warning signs should trigger an assessment by a doctor or nurse practitioner. He or he will also make sure that the medication does not interact with your other medications, that you are not likely to be allergic to the medication, that the dose is appropriate for your kidney function, and that there are no known drug-drug interactions. The pharmacist will notify your doctor or nurse practitioner if a medication is prescribed so that he/she is aware of your change in health and of the new medication therapy. You can get the prescription filled at the pharmacy of your choice.

While Medicare covers the assessment and prescribing, patients are responsible for the usual pharmacy professional fees and the cost of prescribed medications, however those with prescription drug insurance plans may submit claims to their insurance provider.

If at any point, you develop fever (temperature greater than 38.3 C), chills, or new lower back/ flank pain, then you should be evaluated in person by a doctor or nurse practitioner in a timely fashion, to rule out a kidney infection or some other medical issue.

Before you head to the ER for treatment of an uncomplicated UTI or other minor ailment, talk to your pharmacist about how they can help.

Dr. Kevin Duplisea is a pharmacist at Sharp’s Corner Drugstore in Sussex, New Brunswick. 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.

Sussex pharmacist Kevin Duplisea dispenses information and advice on a wide range of pharmacy questions in a regular column published in several newspapers.

If you have a question you’d like to see answered in his column, you can send it to him at AskYourNBPharmacist@gmail.com

 
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