Physiotherapists in community pharmacies? Study asks why not

Will we one day see physiotherapists working with pharmacists in community pharmacies to offer services and advice to clients suffering from musculoskeletal disorders (MSDs)? This is the scenario on which a Quebec researcher, Luc J. Hébert, and one of his master's students, physiotherapist Joanie Bédard, are currently working. Hébert is himself a physiotherapist, director of research, radiology and nuclear medicine at the Faculty of Medicine at Laval University and a researcher at the Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) in Quebec. He is, with another of his students, Rose Gagnon, the originator of a pilot project which led physiotherapists to work in the emergency room of the University of Laval Health Centre (CHUL) with the emergency physicians. This project was successful and today, physiotherapists practice in the emergency rooms of the five sites of the University Health Centres of Québec. Hébert now aspires to have physiotherapists work in community pharmacies in support and as complementary practitioners with pharmacists. Hébert recalled that there was already a framework of collaboration between the Order of Pharmacists of Quebec (OPQ) and the Professional Order of Physiotherapy of Quebec (OPPQ) in 2015. Under that framework, pharmacists and physiotherapists could share certain information on medications taken by the patient with the patient's consent. This ability, however, was not widely used. Read: Pharmacists play range of roles in opioid stewardship: study Innovative model of care The new study, led by student Joanie Bédard is entitled: “Collaboration within community pharmacies in Quebec to improve access to physiotherapy services.” She suggests an innovative model of care that involves interprofessional collaboration between physiotherapists and community pharmacists. “The high prevalence of MSDs combined with a lack of accessibility to primary physiotherapy care leads us to want to develop physiotherapy services in less conventional settings,” she explains. The desired goal is increased access to frontline physiotherapy services which will allow faster treatment of musculoskeletal disorders and reduce the risk of conditions becoming chronic. It should also lead to a reduction in costs, pain and persistent disability. ” Help unclog emergencies Hébert’s vision also relies on pharmacies to offer front-line physiotherapy to the population. “The wonderful thing about pharmacies,” he says, “is that they are everywhere, they are open every day, even in the evening, and the pharmacist is a professional who is easily accessible. They see a lot of patients with MSDs. All of this could mean that it is a service to the community that could help us relieve several hospital emergencies.” A pilot project that could be carried out in 2022, should provide a good idea of what this model could look like, he says. “At the pharmacy, we could do the same type of physiotherapy consultations as in the emergency room (note: In the ER, physiotherapists assess, advise, but do not give treatment). Patients come to pharmacies seeking technical aid for walking, a bandage, orthotics. Physiotherapists in pharmacies would be in a good position to advise them. Since they have a course of a few credits in pharmacology, they could also say to the pharmacist: “Here is what I noticed while evaluating this case, it would perhaps be necessary to adjust the medication or to suggest one.” The researcher and his student involved the Quebec Order of Pharmacists and the Association of Owner Pharmacists (APPQ) in their survey, conducted among community pharmacists to find out their interest in having physiotherapists in their establishment. Preliminary results are very positive. “We expected it to be well received, but we were surprised at the receptivity,” says Luc Hébert of the positive results. Pharmacists see that a large percentage of people struggle with MSDs. They are able to give advice to these patients, but if there was a physiotherapist on site, we could go further in the process. ” Read: Pain management: topical analgesic preparations for pain The next step will be to hold discussion groups with pharmacist owners who have already had an offer of physio services and others who have never had one. The goal of this second step is to understand the barriers and facilitators for such a project. The question of a consultation space dedicated to a physiotherapist will probably be raised, as will the remuneration of the physiotherapist. Hébert wants this potential service to be free for customers. “We don't want this to be a paid service because we want to reach the population which is socially and financially vulnerable. Money will be an obstacle, but we'll see when we get there and how we can finance such a service.” They will have to demonstrate to the Ministry of Health that financing the presence of physiotherapists in community pharmacies would be beneficial for the entire health system, especially for hospitals, emergency rooms and family practice groups, and demonstrate a reduction in costs elsewhere.

Physiotherapists in community pharmacies? Study asks why not

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