Pharmacists now prescribe for minor ailments

By Renu Pillay

A pharmacy has traditionally been the first point of contact for patients with minor ailments. Minor ailments are described as health conditions that can be managed with minimal treatment or self-care strategies, often with the help and advice of a pharmacist. Typically, patients would get free advice and a suggestion from the pharmacist about the best over-thecounter options. The pharmacist would also assess and advise the patient if the condition had any red flags that would suggest the need to go to their family doctor or a walk-in clinic. This system has worked well over the past 200 years since Ontario’s first pharmacy opened in Picton in 1827.

Now, under new rules that took effect on January 1, Ontario pharmacists can prescribe certain medications that were previously only available after a visit to a physician or registered nurse practitioner. Any patient with an Ontario Health Card is eligible for this service and the assessment is free to the patient.

In essence, this is just an extension of the pharmacist’s traditional role, but it does call for more rigorous assessment and follow-up procedures to ensure that the prescribed treatment is safe and effective.

The change is designed to take some pressure off Ontario’s overburdened healthcare system, which is experiencing a dire shortage of primary-care physicians and nurses. It will not replace doctors and nurses; rather it will complement the valuable services they continue to provide.

The process will usually involve a 15- to 20-minute consultation with a pharmacist. This can be done over the phone, online or in person. The pharmacist will assess patients based on their symptoms, history and lifestyle. The pharmacist will use his or her knowledge and, with the help of a sophisticated software system, will identify if the patient can be safely and effectively treated with a prescription. If any red flags come up, the pharmacist will refer the patient to a primary-care health provider. The pharmacist will usually follow up with the patient within a week to determine the outcome of the treatment and will make further suggestions if necessary. After the consultation, a copy of the assessment and treatment prescribed will be forwarded to the patient’s family physician.

The 13 ailments that can be treated are as follows:

1. Allergic rhinitis

2. Candidal stomatitis (oral thrush)

3. Conjunctivitis (bacterial, allergic and viral)

4. Dermatitis (atopic, eczema, allergic and contact)

5. Dysmenorrhea

6. Gastroesophageal reflux disease (GERD)

7. Hemorrhoids

8. Herpes labialis (cold sores)

9. Impetigo

10. Insect bites and urticaria (hives)

11. Tick bites, post-exposure prophylaxis to prevent Lyme disease

12. Musculoskeletal sprains and strains

13. Urinary tract infections (uncomplicated)

Pharmacists have a formulary of drugs that are available for each condition and they are qualified to choose the most appropriate treatment based on the assessment. The pharmacist will ensure that the medication prescribed will be safe and effective and will not interact with other current medications. Do not be disappointed if your pharmacist cannot prescribe anything after your assessment; it’s probably because your condition requires a referral to your physician.

You may fill the prescription at the pharmacy that provided the assessment, but you can also choose to go to another pharmacy. The cost of the assessment is paid by the province, but patients must pay for the prescribed medication – that cost might be covered by private insurance (or OHIP coverage if you qualify.)

Pharmacists have been asked to step up in Ontario to assist with flu shots, travel vaccines and COVID-19 vaccines and it has always been a privilege for us to help in providing these essential services to our communities. The addition of minor ailment prescribing is a welcome addition to the scope of our practices; we believe it is a safe and effective way to relieve some of the pressure on our healthcare system. Because assessments take time, you may need to schedule an appointment. Most pharmacists will be able to accommodate you within 24 hours. As always, your pharmacist will aim to be a fast and efficient resource for your community.