Six more ailments please: Ontario wants its pharmacists authorized to prescribe for additional conditions

Just weeks after Ontario pharmacists became authorized to assess and prescribe for 13 minor ailments, the province’s Health Ministry has asked the profession’s regulator to make changes that would enable autonomous prescribing for six more conditions. “The (Health) Ministry is asking for this to be done quickly—with urgency,” Susan James, director of quality for the Ontario College of Pharmacists, said at a March 21 board meeting. “This is a direct request from the Minister.” According to a slide presentation shared by the college during the meeting, the province would like pharmacists’ assessment and prescribing authority to also include mild to moderate acne, canker sores, diaper dermatitis, yeast infection, pinworms and threadworms, and nausea and vomiting in pregnancy. For these additions to take effect, the college would need to amend regulations to include the six additional conditions. James said there would be no need to change any of the provisions within the regulations for minor ailments prescribing. “The regulatory change is strictly to add these six ailments to the schedule, along with the drugs that go along with that,” she said. Read: ‘Abusive is an understatement’: Pharmacists angered by Ontario’s plan to clawback payments for another year As of the end of February, Ontario pharmacists have completed 86,000 assessments and issued about 70,000 prescriptions for minor ailments, said James, citing numbers provided by the province. The latter figure, she noted, is an indication that Ontario pharmacists do a good job of considering a wide range of interventions, not just prescribed medications. Board members passed a motion to ask the province to waive the 60-day stakeholder consultation usually mandated for all regulatory changes. In response to a pharmacist who said she felt “leery” about not having the consultation—and also wondered if there might be “pushback” from pharmacists already stressed from their current responsibilities—James explained that the six ailments the province wants added had been included in the original list in 2019 when the college was developing the regulation process for minor ailments prescribing in Ontario. That process included a 60-day consultation that also covered all of the proposed ailments. But the province decided to proceed without the six ailments it now wants added to the schedule. “This was a government that wanted to move forward with an expanded scope but do so more slowly—this was back in 2019, a different environment, so they felt we could start small and add to it,” explained James. Based on feedback from pharmacists, the six ailments were left out because it was thought putting them within the scope of pharmacy would have less impact on emergency room visits than the 13 other ailments that were included in the finalized regulation. Read: Minor ailments: What do pharmacy students think? Once all approvals and regulatory changes go through for the six additional ailments, getting pharmacists ramped up to assess and prescribe for them should be fairly quick and easy, said James. “The (Ontario Pharmacists Association) has courses ready for this,” she said. “And pharmacists will have sufficient time to upgrade. We’re not looking to have this implemented before everything pharmacists need is in place.” As part of future discussions with the province about the six additional ailments, the college will likely bring up the possibility of expanding pharmacists authority for point-of-care tests and lab test requisitions related to the ailments for which they’re authorized to assess and prescribe. “(The province) is encouraging us to take a look at those ailments that would require authority expansion,” said James. Read: Prescribing for minor ailments—a prime opportunity to advance our profession

Six more ailments please: Ontario wants its pharmacists authorized to prescribe for additional conditions

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