Abstract
The Ontario Pharmacists' Association (OPA) has moved quickly to respond to the provincial government's interest in exploring expanding prescribing rights for a number of health professionals, including pharmacists.
The OPA wrote to George Smitherman, then Ontario's Minister of Health and Long-term Care, on June 9, 2008, to request discussions on the appropriate scope of practice for pharmacist prescribing and on the timing for such a change. And the Association will soon send a submission to the Health Professions Regulatory Advisory Council (HPRAC), which is also considering whether nurse practitioners, midwives, and optometrists should be given the right to prescribe a wider range of medications.
Ontario is stepping into the pharmacist prescribing arena somewhat late in the game; Alberta has already implemented the change, and several other provinces (New Brunswick, Manitoba, and British Columbia) are in the process of doing so.
There has been little public discourse on prescriptive authority for Ontario pharmacists, but in June the former health minister revealed his government's intention to study the matter. “You are seeing more and more the capability of the pharmacists being unlocked to serve patients,” said Mr. Smitherman (Canadian Press, June 1, 2008). “I think it's an appropriate thing to take a look at. Obviously it's got to be done with … an abundance of caution on behalf of patients but also recognizing that, for patients, it can be a matter of extraordinary convenience.”
— Dennis Darby
chief executive officer of the OPA
“In Ontario there is a lot of pressure on the health care system, and I think Mr. Smitherman was articulating his desire to have more health professionals step up and play a bigger role in its delivery,” said Dennis Darby, chief executive officer of the OPA, in an interview with the CPJ. “Pharmacists already play an important role but we can do a lot more. So we are looking forward to having this conversation with the government.”
Need to share more health information
Giving pharmacists the authority to initiate, continue, and modify some prescriptions will dramatically improve the safety and effectiveness of drug therapy in a very cost-effective way, the OPA said in its letter to the former health minister. What's also required, the letter stated, is a breakdown of barriers in the management of health information, with greater pharmacist access to therapeutic and diagnostic information about patients to support an expanding prescribing role.
“I think the establishment of electronic health records in Ontario will be critical for effective collaborative care,” says Mr. Darby. “Right now drug records are held in pharmacies. It would be great if doctors had access to that information and likewise pharmacists had access to lab test results to help them in caring for patients, especially for the management of chronic diseases such as hypertension and diabetes.”
As discussions move forward, Mr. Darby adds, the OPA will continue to develop positions in cooperation with the Ontario College of Pharmacists and the universities that educate pharmacists. “If some level of prescribing does emerge, we'll need to provide education to allow pharmacists to add that capability, just as we have done for the MedsCheck program.” (MedsCheck is the pharmacist medication review service funded by the Ontario government.)
Ontario's decision to explore prescribing rights for pharmacists is also welcome news for the Canadian Pharmacists Association (CPhA). More provincial governments are recognizing the link between health care reform and expanding the role of pharmacists, says CPhA executive director Jeff Poston: “Governments recognize there has to be a change to ensure the sustainability of the health care system. At last, they are realizing the full potential of pharmacists as both experts in drug therapy and easily accessible health care professionals.”