How well is Ontario doing when it comes to pharmacist prescribing for dermatology problems?

Getting prescriptions for minor dermatologic issues from pharmacists is proving to be popular in Ontario, but mostly among urbanites and people who already have access to primary care.And while a study in the British Journal of Dermatology shows a high level of demand for pharmacist-prescribing, it also found that those who may need it the most, such as those without access to primary care, aren’t yet engaging. “Disparities in access were observed, particularly among underserved populations, including newcomers, racialized communities, and rural residents,” said Dr. Rita Iskandar, study coauthor and a post-doctoral researcher at the University of Toronto.Pharmacist prescribing for minor ailments was introduced in Ontario January 2023, and currently pharmacists are authorized to assess and treat 19 minor ailments, seven of which are skin-related: dermatitis, cold sores, impetigo, insect bites and urticaria, tick bites, mild acne and diaper dermatitis.The study was conducted to determine how much the pharmacy service is being used in comparison to patients using services for these minor conditions in other parts of the Ontario healthcare system.A population-based cross-sectional study was conducted using data from several province-wide databases to determine minor ailment services, prescription and prescriber data, physician visits and more. The researchers focused on five of the seven allowed skin-related minor ailments.It was found that for all of the 2023 year, the overall pharmacy minor ailment services were accessed by 547,673 patients throughout the province. Of these, 112,718 (21%) were for skin-related conditions, with 85% (96,109) receiving a prescription from a pharmacist. The most common skin conditions pharmacists helped with were dermatitis which made up 35% (39,365) of cases and herpes labialis 41% (46,659). People aged 35 to 64 years were the largest age group to receive skin-related services number 53,302 (47%) getting care for skin-related conditions. More than half, 62% of those who received the services were female.“This uptake highlights the growing role of pharmacists in front-line healthcare delivery. Pharmacist-led care has the potential to help alleviate pressure on overstretched primary care services and contribute to a more integrated, team-based approach to healthcare,” said Dr. Iskandar.Urban residents accounted for 70% (79,203) of people who turned to pharmacists for skin conditions, a percentage that aligns with Ontario’s population in general.However, it turned out that most patients 90% (101,283) already had a regular source of primary care. This was a surprise because “the program aims, in part, to improve care for those with limited primary care access, early users were predominantly already connected to a primary care provider,” she said.The study also found that people who used the pharmacy service were more likely to have high healthcare resource utilization and a higher socioeconomic position than the general population.People who lived in neighbourhoods that were more racialized or had more newcomers to Canada were less likely to get prescriptions from pharmacists than the general Ontario population, 46% (51,833) compared to 51% (7,824,809). The findings showed that uptake was less among “groups that often face greater barriers to traditional care,” she said. It’s unclear why some people aren’t using the service, and more study is needed.“This means there are still disparities, and disparities in access to care, diagnosis and treatment persist, underscoring the importance of improving the service’s outreach and ensuring equitable care through it,” said Dr. Iskandar.An unrelated study by Canadian researchers from 2019 in Research in Social and Administrative Pharmacy found there were generally positive reactions to pharmacy prescribing. It did not look at specific areas of prescribing. The study, a scoping review, included 22 studies that described the views and experiences of patients, as well as the views of the public about pharmacist prescribing. It found that the patient experiences with pharmacist prescribing were generally positive and “reported high satisfaction with appointment times, communication with the pharmacist prescriber and the services received.” However, there were some concerns among both patients and the public specifically around perceptions there was a lack of adequate resources to ensure prescribing by pharmacists was safe. These concerns were around pharmacists not having access to medical records, and not having enough staff support to fulfill prescribing responsibilities.The researchers stated that the findings could contribute to ways to develop strategies for addressing these concerns and enhancing public confidence in pharmacist prescribing.

How well is Ontario doing when it comes to pharmacist prescribing for dermatology problems?

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