Feedback deadline was: May 22, 2020
The College has created posting guidelines to support open and constructive feedback that is directly related to the subject matter under consideration. Please read and follow these guidelines when submitting comments for this consultation.
The Minister of Health has asked the College to submit regulations that expand the scope of practice for pharmacists. The College recently submitted regulations to enable pharmacists to: 1) Administer the flu vaccine to children as young as two years old; 2) renew prescriptions in quantities of up to 12-month supply; and 3) administer certain substances by injection and/or inhalation for purposes that are in addition to patient education and demonstration on November 30, 2019 and are currently being reviewed by government. Communication will occur once these regulations are approved by government and therefore are able to be implemented.
The College was also asked to submit a regulation that would enable pharmacists to prescribe drugs for certain minor ailments by June 30, 2020 to improve access to care in the community and reduce the need for emergency or urgent care visits. As a result of this request, the College is seeking feedback on proposed amendments to the General Regulation 202/94 of the Pharmacy Act, Part VII.3 (Controlled Acts) that, if approved, would authorize pharmacists the expanded scope to prescribe medications for certain minor ailments.
Minor ailments are health conditions that can be reliably self-diagnosed by a patient who is familiar with their condition, and managed with self-care strategies and/or minimal treatment. Other criteria include:
- Short-term conditions
- Lab results aren’t usually required to make an assessment or prescribe the appropriate medication
- Low risk of treatment masking underlying conditions
- Medications and medical histories can reliably differentiate more serious conditions
- Only minimal or short-term follow-up with the patient is required
The proposed draft amendments would enable pharmacists to prescribe medications in the American Hospital Formulary Service (AHFS) Pharmacologic-Therapeutic Classification system categories for the following 12 minor ailments:
Minor ailments and corresponding AHFS categories –
The draft regulations would enable pharmacists to prescribe medications within the AHFS categories for the corresponding minor ailment in the chart.
|1. Urinary tract infection (uncomplicated)||
|2. Dermatitis (atopic/eczema, allergic and contact skin rashes)||
|3. Insect bites (including tick bites) and urticaria (hives)||
|4. Conjunctivitis (bacterial, allergic, viral)||
|5. Allergic rhinitis (nasal symptoms from allergies)||
|6. Candidal stomatitis (oral thrush)||
|7. Herpes labialis (cold sores)||
|9. Gastroesophageal reflux disease (GERD)||
|10. Dysmenorrhea (menstrual cramps)||
|11. Musculosketelal sprains and strains||
|12. Impetigo (bacterial skin infection common in children)||
Before providing feedback, you are encouraged to review the proposed regulatory amendments to the General Regulation 202/94 of the Pharmacy Act in sections 35 and 38 and Schedule 4 which has been added. A clause by clause comparison of the draft regulations are available here.
When reviewing and commenting on the draft regulations, please consider:
- the intent of these regulation changes to protect the public and support quality pharmacy care;
- the expectations of the public in making sure the expanded scope for pharmacists is both accessible and safe;
- the expectations of pharmacy professionals that the regulation changes appropriately enable them to apply their current knowledge, skill and ability to perform the expanded scope activities safely.
Expanding scope of practice is intended to enable pharmacists – the health care professionals with the most extensive pharmacotherapy education – to take on a greater role in improving health outcomes by maximizing their knowledge and skills to initiate, manage and optimize drug therapy. In Canada, seven provinces have authorized pharmacists to prescribe for minor ailments, with Alberta being the first province to implement the expanded scope in 2007. Since 2012, Ontario pharmacists have had the authority to prescribe specific medication only for smoking cessation. Under the current Standards of Practice, pharmacists can prescribe based on their assessment of the patient, having collected and interpreted relevant patient information. The purpose of the assessment is not to diagnose, which pharmacists are not authorized to do, but to determine the most appropriate treatment option for the patient. Part of the assessment involves identifying when it would be appropriate to refer to another health care provider and to advise when to follow-up should symptoms not resolve.
In developing the regulatory changes needed to enable the new scope, the College considered the appropriate parameters that optimize the knowledge and skills of pharmacists in an integrated care model while also ensuring the delivery of safe, high quality patient care, improving access to care in the community and the ability to reduce unnecessary emergency department visits.
The proposed draft regulations were informed by feedback from registrants, the public, patient advisors, experts in pharmacy, medicine, public health, health systems research, and anti-microbial stewardship; as well as professional associations and other stakeholders. For more information about the College’s engagement and collaboration activities as it relates to expanding scope of practice, please visit our Expanding Scope of Practice webpage.
Please Note: The intent of this consultation page is to enable and encourage open and constructive feedback on matters that are directly relevant to the consultation topic, in accordance with our posting guidelines. Comments that are not directly related to the consultation topic or that are not in accordance with our posting guidelines will not be posted. Thank you.