Minor ailments two years later—Ontario forum looks back and ahead

Depending on where you stand, it's either already been two years or it's only been two years since the launch of government-supported minor ailment assessment and prescribing by Ontario pharmacists. Regardless, two years is plenty of time for the profession to take stock of the initiative. That was the goal of an event held at the Leslie Dan Faculty of Pharmacy in Toronto on May 8 called Shaping the Future of Minor Ailments Services: Innovation and Excellence Forum. The Network for Improving Health Systems, a partnership between the University of Toronto Leslie Dan Faculty of Pharmacy and the University's Dalla Lana School of Public Health presented the one-day forum as a way to celebrate successes, evaluate how the minor ailments program has impacted both the public and the profession and plan to better equip future pharmacists for a role in primary healthcare.How it's goingStarting the day was a research overview from Mina Tadrous, associate professor at the Leslie Dan Faculty of Pharmacy. Tadrous described the preliminary results of his research project examining the firs two years of pharmacist minor ailment assessment in Ontario. While the data is embargoed pending publication, Tadrous was able to share a few key highlights from his research. Community pharmacists will not be surprised to know that the top three minor ailments assessed by pharmacists were urinary tract infections, conjunctivitis and cold sores. In fact two-thirds of assessments fell into one of those three categories. Allergic rhinitis is the fourth-most assessed condition.What may surprise some is the fact that of the patients being assessed for those top four conditions, the vast majority (over 80%) were attached to a family physician. In fact, said Tadrous, it became clear that patients who are attached to a physician are more likely to see a pharmacist for a minor ailment than are those with no family doctor. These results mirror the early findings from Nova Scotia's pharmacy primary care clinic initiative which also found that patients seeing a pharmacist for a minor issue tended to do so because it would take too long to get an appointment with their own doctor. Interestingly in Tadrous' Ontario research, patients attached to a family health team clinic were more likely to see a pharmacist for a minor ailment than were patients of a fee-for-service physician.Other highlights:Pharmacies with 6+ pharmacists on staff generally performed more assessments than others with fewer pharmacistsParticipating pharmacists noted that area physicians were generally encouraging of their services and were willing to refer patients to the pharmacy for minor ailmentsPharmacists felt that awareness among the public about the minor ailment services offered by pharmacists was still lacking.Read: Update on Ontario's minor ailment fundingAlso at the event, five recipients of the Leslie Dan Faculty Pharmacy Practice Excellence in Minor Ailments Awards were recognized for their contributions to developing and implementing a range of solutions to help pharmacists deliver high-quality minor ailments services.The award recipients are: Autumn Chen, market access associate, Paladin Pharma Inc., who (with supervision from Certina Ho), led a team of PharmD)students, researchers and physicians to develop 14 virtual interactive cases for pharmacists to develop clinical skills in prescribing for minor ailments, along with a scoring mechanism to provide case-specific feedback to pharmacists.Jasneet Dulai, senior pharmacy and operations manager, Pocketpills, who helped to develop and roll out a virtual national minor ailments program, which allows patients to access digital care from pharmacists or through referrals to other health care providers. Associate professor, University of Waterloo and co-founder and CEO of MAPflow, Nardine Nakhla. Nakhla was recognized for her instrumental role in advocating for and defining the scope of practice surrounding minor ailment prescribing that exists today for pharmacists in Ontario; and for creating MAPflow, a dynamic clinical decision support tool that provides evidence-based guidance in a manner that supports current best practices in pharmacy.Kevin Li, senior manager, pharmacy programs, Rexall, who worked closely with a technology partner to integrate a digital platform directly into the pharmacy management system, allowing pharmacists to conduct assessments efficiently and ensuring timely access to care for patients.Jonathan Tsui, owner and pharmacist, Findlay Creek Pharmacy, for adopting the platform MedEssist for his pharmacy to seamlessly integrate minor ailment prescribing into their day-to-day workflow. This platform provided his team with the ability to assess and prescribe for minor ailments at a clinically impactful scale and enabled patients to receive timely and comprehensive care in the midst of a shortage of primary care providers.Also at the forum, a panel of pharmacy, public health and physician leaders shared their perspectives. Economist and health policy advisor Audrey Laporte noted that there will have to be some financial adjustment in the provincial health budgets to encourage providers (including pharmacists, nurse practitioners and others who have seen their scope of practice expanded) to fully integrate their new scope into their practices. Also, she notes, if the complexity of what these other practitioners do continues to rise, then so will the complexity of what physicians do. That will (or should) spur a general rise in compensation levels across all professions.And how to physicians feel about pharmacist minor ailment assessment two years in? What continues to bother Dr Eric Wong of the Ontario College of Family Physicians is the increasing paperwork and communications coming from pharmacists for various reasons. "Think of a physicians inbox," he said. "I typically have hundreds and hundreds of piece of information coming into my inbox all day from patients and others. An extra couple messages from the pharmacy can be the straw that breaks the camel's back." Wong and others reiterated the need for a comprehensive and effective electronic medical record system, preferably yesterday.Later in the day a panel of pharmacy educators described some of the ways minor ailments are being worked into the standard pharmacy curriculum; and how the recent move to allow for more co-education of pharmacists and physicians may help towards more fully integrating this scope of practice into community care.The forum was just the latest event held by the Network for Improving Health Systems, which has hosted similar research- and policy- focused forums in recent years, all with a focus on seeking opportunities for change and improvement in the healthcare system, particularly through maximizing the use of pharmacists and their skills.

Minor ailments two years later—Ontario forum looks back and ahead

Register for free access or login.

Related Topics

Business Topic