BADDECK – Graham MacKenzie has seen a massive change in his opportunities as a pharmacist in recent years.
Traditionally, pharmacists would review a prescription written by a doctor, verify that it had no adverse interactions with other medications they were taking, and fill the order.
Now they can prescribe some medicines for some uncomplicated illnesses and administer a range of vaccinations, some of which also require a prescription.
These changes will help patients get primary care faster than having to see a doctor first, while relieving pressure on emergency rooms and the healthcare system.
“I’ve been working for 30 years and it’s really changed the profession immensely,” he said.
“This extra stuff… really came at an amazing time. Many emergency doctors are gone, like here in Baddeck. We can step in and fill that role, if only a small part of it, but we’re happy to step in and do it.”
Evaluation and drug treatment therapy for uncomplicated urinary tract infections (UTIs) and shingles, as well as for sleep disorders, are among the primary care services pharmacists can now perform.
They can also prescribe refills for people with prescriptions for chronic conditions and, in some cases, review test results to adjust dosages or change medications entirely.
Beverley Zwicker, CEO and registrar of the Nova Scotia College of Pharmacists, said pharmacists already have the skills to do these things. Well, the regulation allows them.
“The pharmacists had the competencies and skills to do this. The system just integrates them into the healthcare model, the primary healthcare model,” she explained.
“It is the system that is making changes to position pharmacists in the primary care model so they can bring the full extent of their knowledge and skills to meet the needs of Nova Scotians.”
FAST DIAGNOSIS, TREATMENT
Waiting hours or days in an emergency room for a doctor’s appointment isn’t ideal for people with symptoms of shingles or urinary tract infections (UTIs).
Pain and discomfort are leading patients to want quick treatment, which can now be provided by a pharmacist.
The pharmacist uses an approved protocol for diagnosis. In some cases, the diagnosis leads the pharmacist to suggest that medical attention from a doctor is required. In others, the pharmacist can draw on their expertise and create the drug treatment plan and prescribe what is needed.
There are costs associated with the test, which are sometimes covered by the Provincial Health Insurance Fund (MSI), as is the case for some vaccinations (COVID-19, influenza). Other prescriptions and vaccinations can be covered in whole or in part by private health insurance.
MacKenzie said the majority of patients he sees don’t mind paying for the exam if it’s not covered by MSI.
“Most people are just glad they don’t have to wait days or weeks to get an appointment with their doctor or spend hours in the emergency room when they don’t have a doctor,” he said.
Zwicker sees great benefits in this expansion of primary care services, which pharmacists now need to regulate.
“The main benefit is that you have the right healthcare provider providing the most appropriate care,” she said.
“So, the breadth and depth of a pharmacist’s drug expertise and competencies is greater than that of any other healthcare provider. They are the drug therapy experts … They have the drug therapy experts, the pharmacists who lead the drug therapy management of the patient.”
Other parts of the province’s healthcare system are also benefiting.
“It shifts that pressure away from the emergency rooms. It shifts that pressure from Virtual Care Nova Scotia, which is also being impacted,” Zwicker said.
“It shifts it away from those other healthcare providers so they can then focus on their unique expertise and meet the care needs for which they are best positioned.”
For more information on what preventive treatments, e.g. For example, if pharmacists may be able to help with Lyme disease or treating illnesses, call a pharmacy or visit the Pharmacists Association of Nova Scotia (PANS) website.
VACCINATIONS
Vaccinations that pharmacists in Nova Scotia can provide:
• Japanese encephalitis
• rabies
• Yellow Fever
• Vitamin B 12 injections
• Tetanus, diphtheria and whooping cough (Tdap)
• Measles, mumps and rubella (MMR)
• Influenza (free with health card)
• COVID 19 (free with health card)
• Pneumococcal disease
• meningococci
• Varicella (chickenpox)
• Typhoid fever
• Hepatitis A and B
• Human papilloma virus (HPV)
• Herpes zoster (shingles)
Who should be vaccinated?
• People who travel
• Vaccination against shingles – people over 50 years of age
• Meningococcal vaccine – Adults and adolescents vaccinated before 2015
• HPV vaccination – women aged 9-45 and men aged 9-45
• Pneumococcal vaccine – people 65 years and older
• Individuals whose vaccines are not up to date
SOURCE: Pharmacy Association of Nova Scotia (PANS)
REGULATIONS
Pharmacists can help with prescriptions for:
• Evaluate and treat uncomplicated urinary tract infections (UTIs)
• Assess and treat uncomplicated shingles
• Preventive medication against Lyme disease
• Birth control
• Refills of medicines, adjustments
• Sleep disorders
• Mild muscle or joint pain
Nicole Sullivan is a diversity and education reporter who sometimes covers health for the Cape Breton Post.
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