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Expanding Scope of Practice: Pharmacist Prescribing for Minor Ailments

Feedback deadline was: May 22, 2020
Summary

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.

CONDITION AHFS CLASSIFICATION
1. Urinary tract infection (uncomplicated)
  • Anti-infective Agents: Antibacterials. Sulfonamides (8:12.20)
  • Anti-infective Agents: Urinary Anti-infectives (8:36
2. Dermatitis (atopic/eczema, allergic and contact skin rashes)
  • Skin and Mucous Membrane Agents: Anti-inflammatory Agents. Corticosteroids (84:06.08)
3. Insect bites (including tick bites) and urticaria (hives)
  • Skin and Mucous Membrane Agents: Anti-inflammatory Agents. Corticosteroids (84:06.08)
  • Antibiotic Tetracyclines (8:12:24)
4. Conjunctivitis (bacterial, allergic, viral)
  • Eye, Ear, Nose, and Throat Preparations: Anti-infectives. Antibacterials (52:04.04)
  • Eye, Ear, Nose, and Throat Preparations: Antiallergic Agents (52:02)
5. Allergic rhinitis (nasal symptoms from allergies)
  • Eye, Ear, Nose and Throat Preparations: Anti-inflammatory Agents. Corticosteroids (52:08.08)
  • Eye, Ear, Nose and Throat Preparations: Antiallergic Agents (52:02)
6. Candidal stomatitis (oral thrush)
  • Skin and Mucous Membrane Agents: Anti-infectives. Antifungals. Polyenes (84:04.08.28)
7. Herpes labialis (cold sores)
  • Anti-infective Agents: Antivirals. Nucleosides and Nucleotides (8:18.32)
  • Skin and Mucous Membrane Agents: Anti-infectives. Antivirals (84:04.06)
  • Skin and Mucous Membrane Agents: Anti-inflammatory Agents. Corticosteroids (84:06.08)
8. Hemorrhoids
  • Skin and Mucous Membrane Agents: Anti-inflammatory Agents. Corticosteroids (84:06.08)
  • Skin and Mucous Membrane Agents: Antipruritics and Local Anesthetics (84:08)
  • Skin and Mucous Membrane Agents: Miscellaneous Skin and Mucous Membrane Agents (84:36)
9. Gastroesophageal reflux disease (GERD)
  • Gastrointestinal Drugs: Antiulcer Agents and Acid Suppressants. Histamine H2-Antagonists (56:28.12)
10. Dysmenorrhea (menstrual cramps)
  • Central Nervous System Agents: Analgesics and Antipyretics. Nonsteroidal Anti-inflammatory Agents. Other Nonsteroidal Anti-inflammatory Agents (28:08.04.92)
11. Musculosketelal sprains and strains
  • Central Nervous System agents: Analgesics and Antipyretics. Nonsteroidal Anti-inflammatory Agents. COX-2 inhibitors (28:08.04.08)
  • Central Nervous System agents: Analgesics and Antipyretics. Nonsteroidal Anti-inflammatory Agents. Other Nonsteroidal Anti-inflammatory Agents (28:08.04.92)
12. Impetigo (bacterial skin infection common in children)
  • Skin and Mucous Membrane Agents: Anti-infectives. Antibacterials (84:04.04)
  • Skin and Mucous Membrane Agents: Anti-inflammatory Agents. Corticosteroids (84:06.08)

 

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.
Submission

Background

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.

Read The Feedback
195 COMMENTS
  • pharmacist - POSTED March 25, 2020

    Good day, Although I think that it is a great step forward if this is approved, I still think it is not enough. Pharmacists have several years more training in pharmacology compared to doctors, thus, as you mentioned, pharmacists should not be diagnosing, but doctors should not be prescribing at all. A doctor is a specialist in diagnosis and a pharmacist is a specialist in treatment. I’m from South Africa where doctors have pharmacology for 6months compared to pharmacists with 4 years training in pharmacology. The number of prescriptions received from doctors with incorrect treatments plans are shocking, because they simply do not have the knowledge, they use standardized treatment plans from a book. So yes, pharmacists should be allowed to prescribe, ALL medicine. Doctors can recommend a prescription, but pharmacists should have the final say and be able to change anything on the prescription. Lastly, the reason why I am commenting from SA, I will be emigrating to Canada as soon as this pandemic is sorted. From an activist for the pharmacy profession.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : +27849912440
    Organization name : N/A
  • pharmacist - POSTED March 25, 2020

    I support the expansion of the scope of pharmacists to prescribe treatment for minor ailments. This would help improve the efficiency of care for Ontario patients, and it has been shown to be a successful strategy in seven other provinces already.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED March 25, 2020

    I absolutely support this expansion of pharmacist scope due to our accessibility to the public and our knowledge and understanding of these minor ailments. I hope to continue to support our patients in any way possible and look forward to moving forward with these regulations.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED March 25, 2020

    Dear OCP I am disappointed by the unnecessary caution taken in drafting this list. I find this list to be quite limited in scope, both in general as well as in comparison to other jurisdictions. I recommend you take this back to consider a significant expansion. As a starting point to the expansion, I would highly recommend adding that pharmacists can legally prescribe anything that is Schedule 2, 3 or unscheduled. We already recommend these products, so they are clearly within our scope. This will assist patients with drug coverage for medications they may not otherwise be able to afford. For example, many plans cover treatment for vaginal candidiasis but that is not on your list. This means a low income woman with drug coverage must take time away from work/family to make an unnecessary visit to the doctor for a prescription. This is a waste of her time/money as well as health care resources. Additionally, there was no consideration given to prescribing for contraception. (Was a gender lens applied in making this list? I note that the “missing” conditions predominantly affect women) Oral contraceptives and emergency contraception (including Plan B as well as Ella) must be considered as an essential preventative health service and access to BCP should not be contingent on Pap tests. I am relieved PPIs are not on this list as they are prone to misuse and complications. Notably absent is shingles. Treatment must occur in a short time period and pharmacists are ideally place to deliver. Also: Lyme disease is increasing in prevalence and there are standardized post-exposure protocols. again that must occur within a short window, that could easily be implemented in a pharmacy setting. These are simply the ones that come to the top of my mind. There are undoubtedly others. Other provinces have proven the utility of pharmacist-delivered prescribing while we have lagged far behind. Please do not squander this opportunity to improve health care delivery in Ontario.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED March 25, 2020

    My only concern is the timeline of June 2020. Assuming we are still in the middle of a pandemic, community pharmacists will still be trying to limit close contact with patients. Since every scope change comes with extra education and documentation requirements, I predict it will force us into closed rooms with patients to properly assess and document, get a signature of consent, etc without any kind of PPE available. Not to mention the extra workload it will add when many teams are already working with a skeleton crew due to either assistants staying home for their own safety or having to segment staff into siloed teams to limit the fallout should one team member contract Covid-19. I have no issue with minor ailment prescribing, in general. I even took a workshop course in preparation 2 years ago when talk really got going about it. My only issue is the timeline.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 2266220805
  • pharmacist - POSTED March 25, 2020

    I approve these new regulations but need more information on how to apply.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED March 25, 2020

    Whilst this a step in the right direction, the list provided is very limited. The Pharmacist should be able to do what the walk-in doctors do..they write a prescription for a patient for a patient and disappears ..leaving all the responsibilities to the Pharmacist to address all the issues eg. allergy, interactions etc. If we are to expand the scope of practice for the Pharmacists, we have to increase the listed conditions. Right now, in this pandemic situation, the Pharmacists are performing so much advisory role ..talking to the patients, constantly on the phone..and not getting paid one cent for these services. At this point of time Physicians on the telehealth are being rewarded by OHIP …Why these disparities..I care for the profession and I care for our patients..The Pharmacists are very capable of prescribing …with the expanded list

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 4167163196
    Organization name : AJAX PHARMACHOICE
  • pharmacist - POSTED March 25, 2020

    I don’t support any expansion in pharmacists’ scope of practice without mandatory reimbursement criteria. We extend and adapt prescriptions now without payment for the most part. We do thousands of flu shots for very little money after supplies costs and time are taken into account. This means we are spending time and accumulating liability without being paid for it. Until OCP mandates that pharmacists and pharmacies must charge for services, ALL pharmacists should oppose any expansion of scope including for minor ailments.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 4169602323
    Organization name : The Village Pharmacy
  • pharmacist - POSTED March 25, 2020

    Safety should be of great concern for both public and pharmacy members. As COVID 19 has cleary demonstrated there is a move for PHCP (doctors and nurse practitioners) to see and assess patients by virtual means. Thus I am recommending we “the profession of pharmacy” think about the current practice sites and have amendments that include safe practice sites that include virtual assessments of patients for current and future pandemics. Thus allowing the delivery of this needed service to our community and help free up ER time.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED March 25, 2020

    It is absolutely imperative that pharmacists provide these additional cognitive services with NO expectation of compensation. Minor ailment prescribing by pharmacists is an excellent way for provincial health ministries to contain spiralling costs. Take the above chart of eligible ailments, for example. If a physician saw 12 such patients with the listed conditions, he/she would bill the Ministry of health for $400 or more. A pharmacist would now be able to provide these services at no cost to the Ministry, saving tens if not hundreds of millions of dollars annually. These savings could be spent developing critical health infrastructure concepts like eHealth for every resident of Ontario. Minor ailment prescribing would greatly enhance professional satisfaction among pharmacists by removing them from the transactional drudgery of dispensing and counselling on prescriptions. As community pharmacies evolve into a model with A pharmacist could look forward to spending 30 minutes of each hour interviewing and meticulously documenting minor ailment encounters with patients.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : Independent community pharmacist
  • pharmacist - POSTED March 25, 2020

    I agree with expanding Pharmacists role under 2 conditions; 1. All pharmacists to undergo mandatory certified educational program similar to cannabis education, this would ensure standardized practice. 2. Employers must do better to provide extra help for pharmacists. Dispensing staff need to be better educated instead of just qualified technicians, we must raise the standards so pharmacists do not feel rushed to perform like robots. No doubt there will be paperwork involved so it must be kept simple. We must put in place measures that ensure that patients receive the best care and not as how some pharmacies conduct poor Medschecks just to bill the government. Lets do this right!

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 6134911515
  • pharmacist - POSTED March 26, 2020

    I am in full support of prescribing for minor ailments. Many patients do not want to take time off work to see their doctor for something “minor”, we can be accessible. We should get compensated for it, just like the other provinces. Also, can we include sinusitis and pharyngitis to the minor ailments, and able to prescribe antibiotics for them? I see we can prescribe corticosteroids for them, if we can add antibiotics as well for those conditions that would be complete.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : Riverbend Pharmacy
  • pharmacist - POSTED March 26, 2020

    I am very interested. I would also like to know if Pharmacists’s will get ohip billing rights or how we will be paid for our services

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 5194916778
    Organization name : London Road pharmasave
  • pharmacist - POSTED March 26, 2020

    Dermatitis/ insect bites could be accompanied by fungal or bacterial infection such as: chronic diaper rash with fungal infection or children insect bites that are scratched and started to develop a bacterial infection. Both cases would required an antibiotic/corticosteroid or antifungal/ corticosteroid topical combination.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : Rexall
  • pharmacist - POSTED March 27, 2020

    For UTI’s I would be more comfortable if there was a process by which the patient could provide a urine sample that would be sent to a lab before the empiric antibiotic was given to the patient, so that drug therapy could be changed appropriately if the culture and sensitivities of the urine sample came back resistant for the antibiotic prescribed.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 6136561588
  • pharmacist - POSTED March 27, 2020

    It does concern me that lab work may not be checked when prescribing certain medications renally cleared and I think we should make it mandatory to check labs. It worries me that pharmacists will not have adequate and consistent training across the board before prescribing. Please make sure they have to have proper training for sure.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 5196961119
    Organization name : Grand River Hospital
  • pharmacist - POSTED March 29, 2020

    I am a Pharmacist. The list provided above is a good start. But as most of my pharmacist colleagues mentioned in their comments, it is still lacking lots of other topics. I find Ontario way behind other Provinces. Please look at the scope of practice in Alberta! What are the results, pros & cons of pharmacists prescribing? Can we learn from the experiences of other provinces & modify the practice based on their outcomes? Please move forward with the suggested scope. Ontario is in desperate need for legislating the help that we are already providing. I also suggest we start looking at the next set of minor ailments that we can add to the the list above. Several topics have been mentioned in the comments that can be added. Constipation is another example. Lots of schedule 3 medications are covered by ODB & just need a prescription to get it covered. I think I have clearly made my point. Hope to see this happening in the next few months.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED March 29, 2020

    I am against the proposed prescribing of minor ailments as it is a major conflict of interest to be both prescribing and dispensing for a patient. The only way I see this being resolved is if any prescriptions initiated by a pharmacist must be filled at a completely unrelated pharmacy, so that there is no financial conflict of interest and no pressure from owners to write unnecessary treatments.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • Other - POSTED March 30, 2020

    Minor ailments prescribing , good change to provide more care to patients and show how expert are pharmacists. Injection to children than 5 y may not be appropriate in pharmacy.

  • pharmacist - POSTED April 3, 2020

    I think it is not a bad idea but we need to qualify for it and do more CE to reach the level Possibly also limitation to less than what is mention is good. I would not suggested treating Impetigo or complicated UTI.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : Myself
  • pharmacist - POSTED April 3, 2020

    OCP needs to have some involvement with the remuneration piece advocacy as it relates to pharmacist uptake and overall system benefits. Payment by government to pharmacy must be inclusive of all Ontarians and must be absent of any co-payment. Otherwise patients will gravitate back to primary care for minor ailment assessment in order to save themselves money. Otherwise pharmacist uptake will be piecemeal at best and will not effectively contribute to government system goals.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : MacTavish Pharmacy
  • pharmacist - POSTED April 3, 2020

    I feel that we need to get this done as we have lagged behind most of the other provinces by years. Once we have it in place we can adapt it, add more categories, etc. Education must be mandatory to provide these services. Right now it is more important than ever. I feel this should be made available right now.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 7052824124
  • pharmacist - POSTED April 5, 2020

    I am happy we are moving forward with this initiative however just like when the Fee Schedule came out years ago, pharmacies in general have not been charging for these services. Whenever I extend a prescription I tell my patients that there should be a $15 charge just so they at least know there is value in my work. Considering we do most of the functions on this list with many OTC products already I am fine with these changes but ONLY IF we are going to get paid by the government for easing the strain on the healthcare system and reduce wait times for family docs etc. It is ridiculous that the government pay for a MD visit to assess a bug bite and the prescription is HC 1%. The cost to the system is $50 versus paying the RpH a fraction of the amount. Moreover, please do not make the assessment and record keeping more arduous than it needs to be. That will help no one in the end. Finally, this COVID crisis should make pharmacists stand up and ensure our value is recognized and remunerated. Thanks

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 9054675745
  • member of the public - POSTED April 7, 2020

    I am in agreement that pharmacists have an expanded role in determining the best medication to be used for a condition or illness. They are highly trained professionals and know the uses and effect of drugs, more than many doctors.. If the customer always uses the same pharmacy to fill their prescriptions and the pharmacists are stable, then it may be OK to expand services. I fear that pharmacists that work as employees such as at Walmart or Cosco, rather than co-owners of a pharmacy, may not be working in a consistent fashion, ( greater staff turn over or shifts) and may not get to know their customers. Safeguards must be put in place for those circumstances.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 6137295998
  • member of the public - POSTED April 7, 2020

    I am supportive of the proposed changes. I feel that many patients have a closer relationship with their pharmacist than their Dr. as they are often easier to reach. It would also likely decrease emergency visits.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED April 7, 2020

    I am looking forward for this expanded scope of practice as this will enable me to help many patients faster and reduce the healthcare expense by reducing visit to clinic/hospital.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED April 8, 2020

    I think this is overdue. Have always found my pharmacologist very helpful when asked for advice plus have to wait weeks for appointment with family doctor.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED April 8, 2020

    I support the proposed change. However I always had a question on my mind since the first time the change was initiated. My understanding is that medical doctors have extensive insurance coverage for medical error in case it does happen. Do pharmacists have similar protections in case an error/accident happen? Are they covered?

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Organization name : NHSS
  • pharmacist - POSTED April 9, 2020

    I agree totally with proposed amendments if only will be compensated by revenue. These extra services should be fully recognized and compensated by ODB and all private insurance. But if it will be an extra burden and responsibility for pharmacist with no compensation, then we don’t need it. We have proven during the evolving crisis of Covid 19 that we are fully responsible towards our communities and taking a huge risk from sick people and we are not yet compensated for anything

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 9058764466
    Organization name : Medicine shoppe
  • pharmacist - POSTED April 9, 2020

    I have been working in a clinic based community pharmacy.I see very commonly those medical conditions in my practice mentioned under minor ailments.Most of the time my patients have been asking to me the name of the medications for the medical conditions they have.I always assess the conditions first and then write down the name of medications and give it to them.Of course, i get the prescription for almost the same i recommended.That means,i have been prescribing it regularly in my practice indirectly.We as being a pharmacist have educational backgrounds and skills to assess the patient and to recognize the right medications to treat those conditions.Hence,i STRONGLY RECOMMEND to provide the prescribing privilages to the pharmacists.This will certainly help to reduce delayed treatment, reduce the load to the doctors and also reduce unneccessry waiting time for the patients. ALSO,i want to take the attention of the college to prepare the pharmacists to fight against pandemic situations like COVID 19 by providing extra live or online training as necessary.Pharmacists can help in the hospital or clinical settings in this pandemic situations.I see Alberta has already started to recruit pharmacists to fight against COVID 19.I think ontario is lacking behind.Finally,I request the college to make a system to utilize the clinical skills of the pharmacists fully.Thanks

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED April 11, 2020

    This is a start in the right direction.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • Other - POSTED April 11, 2020

    I agree with the above categories but would also like to suggest the addition of diabetic supplies, asthma emergency inhalers (Ventolin, Bricanyl and Symbicort) and Epi-Pens. Thank you for your time.

  • member of the public - POSTED April 11, 2020

    I wholeheartedly support allowing pharmacist to prescribe medications for minor ailments and injuries.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED April 12, 2020

    Fully support this initiative. Agree that this will reduce emergency visits to our hospitals.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED April 12, 2020

    This has been happening in so many jurisdictions so it is almost a no brainer if we actually do care about the public interest and not just protect the scope of practice of other health care professionals . Walk in clinics are closed. Doctors offices are closed. Patient are desperate and pharmacies are open . Let’s allow them to help patients We need to get this approved

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 4169038442
  • pharmacist - POSTED April 12, 2020

    My concern is documentation and follow up time. Doctors’ paperwork takes on third of their time. That is about 20 hours a week. Do pharmacists have the time or fund to do the documentation right? We all know that pharmacists are struggling to document patient interactions such as consultation, counselling, smoke cessation prescribing, prescription renewal and adaptation.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 6132252225
    Organization name : Ultracare Compounding Pharmacy
  • member of the public - POSTED April 12, 2020

    These sound like excellent suggestions! Even before Covid 19, ER’s and doctors in general were being clogged up by people who need prescriptions for the ailments included in this proposal. By allowing pharmacists to proscribe, under the terms suggested, could greatly relieve the bottlenecks in hospital ERs and allow doctors time to see patients who need a greater sophistication of diagnosis.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • Other - POSTED April 13, 2020

    I just wanted to provide a counterargument to a common argument made by opponents to pharmacist prescribing, which is that it puts patients at risk when ailments that appear to be minor are, in fact, signs of something that requires investigation. Pharmacists in PharmD programs DO receive training on minor ailments, and one of the important components we are trained on is when to refer to a physician. Just as a family physician knows when to refer to a specialist or to the emergency department, pharmacists know when to refer a patient to their family physician or to the emergency department. For this reason, allowing pharmacists to prescribe for minor ailments would free up physicians’ time for assessing more complex illnesses, without putting patients at risk.

  • Other - POSTED April 14, 2020

    I agree that Pharmacists should be able to help patients with medication renewals. Patient injections. Also patient care in general. My spouse and I are moving to a rural area in Northern Ontario where we will not have access to a Family Doctor. A Pharmasist would be very helpful by keeping us out of Hospital Emergency Rooms. Thank you

  • member of the public - POSTED April 14, 2020

    This makes total sense, particularly if you’ve had the issue before and your pharmacist knows exactly what treatment works for you. I would certainly trust my pharmacist to handle all these conditions.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED April 14, 2020

    I’m a strong advocate for minor ailments implementation in Ontario as it is already implemented in other provinces and it was very successful and reduced the burden on ER in hospitals as patients trust their pharmacists and consult them for guidance when they needed any advise for their health issues.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : Ana Nefr And Anba Karas Kiromina INC.
  • member of the public - POSTED April 15, 2020

    I do support the expanded scope only on the condition that OCP takes additional steps to protect the pharmacists from being forced into doing to enrich the corporations and to meet the new metrics. It absolutely should not become another metric that the pharmacists are measured on and should only be performed with adequate staffing. There must be a mandatory overlap of pharmacists so that the pharmacist performing the assessment can actually focus on the proper assessment and documentation. No overlap- no service.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED April 15, 2020

    I agree with scope of practice as above. With a couple of areas it is crucial to see history of past meds .I feel it is important that pharmacies co-operate in providing data to each other . If we prescribe for these ailments will drug plans pay or is this to be patient pays only ? thank you

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED April 15, 2020

    I am always impressed by how knowledgeable, and helpful local pharmacists are in providing valuable health information . I would certainly support an expanded role for the profession in their ability to prescribe medications, provided their is a mechanism for oversight.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 705 495-4229
  • pharmacist - POSTED April 18, 2020

    This is really good that we are utilizing our skills to help the public. My main concern is that at workplaces pharmacists are under tremendous pressure to do make huge profits for the pharmacies that they are working for without adequate staffing levels. It is very imperative that adequate staffing levels are provided by community pharmacies in order to free up time for the pharmacists to use the scope and skills fully and safely.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 6475289829
  • pharmacist - POSTED April 18, 2020

    I am in complete support of allowing pharmacists to assess and prescribe appropriate therapy for minor ailments. However, I would recommend everyone to review the AFHS classifications for each minor ailment being suggested for prescribing. For instance, AFHS Classification 56:28.12 only includes ranitidine and famotidine. This is insulting to imply pharmacists are not able to assess appropriate prescribing of proton pump inhibitors when they are part of the treatment algorithm for management of GERD.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : +1 09059157119
  • pharmacist - POSTED April 19, 2020

    It feels as if my merit as a pharmacist is based on the number of Medchecks and injections that I perform in any given shift. I can not help but wonder if new metrics will be applied, with a minimum number of ” New Prescriptions written” being expected at every shift now too. I do not want to inject children who are only two years old. The five years old are squirmy enough. I see problems with authorizing scripts for 1 year ( such as deteriorating health issues in the patient that might be left unnoticed). Will extra pharmacists be hired to do these extra tasks, or will yet more expectations be put upon us without any increased wages for the pharmacist? Certainly pharmacists have a lot to offer, but the idea of expanded scope being forced upon staff pharmacists who often do not get a lunch break and have woefully trained assistants or high school students as assistants is unfair and unsafe. How about improving the working conditions in pharmacies before adding more tasks that will not be reflected in our wages? How about advocating for safe work environments in pharmacies instead?

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED April 20, 2020

    I support this

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 519-364-4936
  • member of the public - POSTED April 20, 2020

    This is a great idea, and long overdue in my opinion. It would be so much easier to visit a pharmacy instead of going to the doctor for the minor complaints listed. Looking forward to this being implemented.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED April 22, 2020

    We , as pharmacists, are abused health care professionals. Many of us have had no increase in wages, for greater than 10 years, with added/increased responsibilities, less qualified help…and higher expectations to meet our employers’ numbers. We have lost many of our trained technicians to hospital settings, to get more suitable wages,..leaving the community pharmacy to find anyone ‘ off the street’ or ‘ from the floor ‘, to learn a job, within a week,..that once took months to learn in a classroom setting. So,..leaving the pharmacist to fend for ourselves,…looking for interactions, ensuring there are no errors,..all within 30 seconds sometimes/Rx. . Then we add, vaccine injections, flu-shots, and now prescribing,..all for the same wages in 2010???? We are the ‘ suckers ‘ of the healthcare system, and its time we get recognized in payment for what we do,..DIRECTLY into OUR pockets,..not into the company.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED April 22, 2020

    This certainly an improvement, yet it fell way short of target. Ontario Pharmacist scope of practice falls behind many of Canadian provinces, and certainly behind many other countries in the world where independent prescribing for pharmacists is on the horizon. I have worked overseas and managed cardiac patients and have certainly improved therapeutic outcomes for the patients and have supported our physician colleagues, who need an average of 45 minutes to establish a preliminary diagnosis for a new patient. We need to see the bigger integrated picture and not waste time on smaller targets, which will ultimately fail the health system and not just the profession of pharmacy. I suggest creating a training program, which is well-structured leading to independent prescribing privilege . A good place to start is to offer similar privilege to that of nurse practitioners. The literature is full of success stories, where specialty clinics run by pharmacists have advanced the quality of care offered to patients in comparison to other healthcare providers.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED April 23, 2020

    I am totally against pharmacists being given the okay for this. Over the last few years I have had to deal with 4 different pharmacies (3 for other people) owned by 4 different companies (all very large) and not one took the fact that they were dispensing medication seriously. I have had the incorrect amount filled with the correct amount listed on the label and charged for, child proof caps put on bottles (the patient specifically asked for NO child proof caps) for rheumatoid arthritis meds, repeats on the doctor’s prescriptions not entered in computer, answered “I guess it’s okay” when questioning if a new med could be taken at the same time as other meds I was on only to learn by experience and library books that it was not okay, etc. Each time the pharmacy notified of issues, just received a blank stare and issues continued. When head office notified, apathetic responses and no action taken. Basically gave the impression of “we are too large and wealthy for you to sue or do anything about this”. Until pharmacists realize and perform with understanding that they are taking people’s lives in their hands dispensing meds and info on meds, they should not be given any other responsibilities that may interfere with, cause reactions or other problems to or in the worst case scenario, kill their patients.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED April 23, 2020

    Provided adequate staffing of the pharmacy and appropriate work environment is in place, common ailment prescribed may be beneficial for the public. If pharmacy owners or directors of pharmacies are not held accountable for a suitable work environment, then it is possible this extra scope will not be beneficial for the public. The AIMS data shows the largest contributor to errors is the work environment. Scope has already been expanded, but owners and directors have under resourced the pharmacy leaving patients at risk of errors or inadequate service delivery. An environment comparable to a doctor’s waiting room is no way to deliver safe effective patient care. Put the pharmacist in the counseling room and provide adequate staffing support. This will maintain patient confidentiality and reduce distractions leading to errors. Counseling by the cash register has to be eliminated.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 14169170361
  • pharmacist - POSTED April 23, 2020

    I think the scope can expanded. We are the most accessible health care professionals we understand medications and their side effect more than prescribers. All the minor conditions mentioned above would relief a lot from the emergency rooms and since walk-in clinics are not as available patient will have access to more care. I think we should get paid for our evaluation and prescribing the medications

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 6137704244
    Organization name : Aylmer St. Pharmacy
  • Other - POSTED April 23, 2020

    I would agree that pharmacists be able to prescribe for uncomplicated problems that people may have.

  • Other - POSTED April 24, 2020

    as a regular sufferer of pneumonia caused by alergy and sinus id like to see pharmacists beable prescribe for that since i have been without a family dr 9 years n been on the wait list n have been turned away from hospital for not having a dr on record for numerous issues past 3 years in northern Ontario.

  • pharmacist - POSTED April 24, 2020

    100% supportive of minor ailment prescribing. Especially during time of COVID-19, when access to clinics and physicians may be challenging, it is critical. RPh scope of minor ailment will free up time for physicians as they diagnose and treat acute, serious health issues and non-minor ailment patients. Please consider – SK has allowed for minor ailment consultation virtually. Minor ailment consultation, from the beginning, should not be restricted by the walls of pharmacy – OCP can take the lead in being progressive and allowing for virtual care from the get-go. In addition to minor ailment, please strongly consider other schedule II and III products that are frequently covered by insurance. For example, lice treatment, ASA81, diabetic test strips, nicotine smoking cessation products, vaginal candidiasis, emergency contraceptive, and I’m sure there are more. Frequently, patients are left paying out of pocket or delaying treatment, despite the fact Pharmacists are able to recommend and sell the product, but unable to officially ‘prescribe’ for insurance claim.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED April 24, 2020

    I am generally in favour of this increased scope of practice. I could have helped so many people over the years, if this had been in place. We need to establish basic documentation requirements…but not onerous ones…an 18 page document like the current MedsCheck document would be too much. Guidelines as to who we can prescribe for should be provided. (must this service only be offered to patients currently on file). Finally to make this financially feasible we should be offered an appropriate fee for this service…since we will be reducing ER/ clinic visits. Education should be standardized and mandated like the cannabis education modules. I have taken a weekend OPA course on this subject, but online modules for each minor ailment should be sufficient to update our knowledge.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 7058627000
    Organization name : Espanola Clinic Pharmacy
  • member of the public - POSTED April 27, 2020

    I have been on the same prescriptions for 10 years or more. I go to the doctor every six months. Unless he feels that the dosage or brand needs to be changed why can the pharmacy not continue to provide my prescription without a new prescription from him.

    YOU ARE A : Member of the Public
    ON BEHALF OF : An Organization
    Phone Number (optional) : 519 352 1657
  • member of the public - POSTED April 27, 2020

    Finally… if only it didn’t take a major healthcare crisis to open up this topic… Often times doctors either don’t know what medications to perscribe or don’t prescribe unless they consult with a pharmacist anyway. I have experienced this myself and I have heard this many times over, where patients would rather be diagnosed and have a prescription directly from their pharmacist, who usually have more time to listen, diagnose and prescribe the right medication. Pharmacists also have stronger relationships and understanding of medication history, so this decision makes much more sense. This also streamlines the patient journey as they no longer need to visit 2 different sites. I support this decision and recommend a larger scope if possible

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 6476488921
  • pharmacist - POSTED April 28, 2020

    I think there should be a required refresher course on said minor ailments including prescribing guidelines, differential diagnosis and red flags. This should be required for any pharmacist that has graduated 5-10 years ago or just make it mandatory for everyone. This is important to protect the public. The OCP needs to set minimum fees for consultations, even those that end without a prescription being offered (example referral because of a red flag). We must untie our clinical services from our products and stop devaluing the profession. This cannot be yet another task already added to our busy days that we are not paid to do. If we want to do this properly we need the time to perform a proper consultation, in order to do that we need to be staffed properly. Remuneration for our services would allow for extra pharmacist hours to provide these services. Many community pharmacists are already stretched to thin during there work day often going without breaks, having hours cut etc. We cannot expect that large businesses are going to add hours out of the goodness or their hearts to allow for extra time for this. We need to set up an expectation of payment for clinical services. I believe this is important to allow for pharmacists to provide these services properly, allowing the time for proper evaluation of the patient and to protect the profession and the public. Pharmacists prescribing will alleviate strain from walk in clinics, dr. offices and emergency rooms, the Ontario government will be paying less fees to doctors and nurse practitioners for these services so there should be a system in place for remuneration from Ontario drug benefit (similar to flu vaccines) for Ontario residents. We are the most accessible health care professionals and often people forget that it takes time to do our due diligence, the OCP must encourage a more clinical atmosphere for these services encouraging setting up appointment times, or informing the public there may be wait times associated (just like at a walk in clinic), otherwise when this roles out to the public it will be another thing people walk into the pharmacy and demand of us, expecting it right away. We are already interrupted multiple times a day for “quick” questions from the public and requests for vaccines (with the expectation that is will be done ASAP), we cannot encourage the public to expect to be in and out in 5 minutes with a prescription in hand. The OCP needs to do this properly and thoutfully in order to protect the profession.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • applicant - POSTED April 28, 2020

    Great idea, this was already applied in other provinces Freeing GPs for more serious cases and in turn GPs will reduce ER admissions.

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
  • member of the public - POSTED April 28, 2020

    This would be such a help to seniors, and many others.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 9054507468
  • other - POSTED April 28, 2020

    If Pcist doing Dr’s Job, Pcist should get paid as much as Physicisn-they are taking same risk and liability as much as dr do.

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • member of the public - POSTED April 28, 2020

    This will help our health care and take load off doctors

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED April 29, 2020

    I believe it is time to allow pharmacists to proscribe medication. These people know more about drugs and there interaction then Doctors.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • other - POSTED April 29, 2020

    Great idea!

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Phone Number (optional) : 7057427151
  • member of the public - POSTED May 1, 2020

    I am a Retired pharmacy assistant. I agree with the new proposal, however, one pharmacist working a 12 hour day will not be able to handle all the responsibilities required to keep a community pharmacy operational. There will have to be more than one pharmacist on shift to serve the public. The wait times for a RX will be tripled even with Pharmacy Tech support. Will the corporations employ the needed staff to make this a reality? I have worked in a very busy pharmacy with one pharmacist who was available for patients questions and concerns. The Rx checking was so backed up that patients were unhappy with the wait which made the workplace a very stressful environment. I’m sure those in community pharmacy know exactly what I mean. Hire more pharmacists to make this work!

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 1, 2020

    As a pharmacist I welcome the opportunity to prescribe for minor ailments, however, I am not convinced community pharmacy is set up to effectively fulfill this expansion of scope. Expectations on the pharmacy profession is for an immediate turn around time of prescriptions being prepared for customers. Such time constraints are not conducive to assessment, diagnosis, documentation, creation of the prescription, filling the prescription and appropriate follow up. Public expectation of the profession is already too high with regards to getting medications into customers’ hands. Furthermore, work has to be done to ensure pharmacists are fairly compensated for these clinical expansions of scope which take significant amount of time away from responsibilities of our current scope of practice. I would also like to point out during this time of crisis we are not being treated in equal footing with respect to PPE equipment distribution as other healthcare professionals. Therefore, I am concerned expansion of scope will force pharmacists to continue to do more with less. We are on the frontline for our patients and we intend to stay there; but unless we are supported, compensated, and the public’s expectations of the profession changed to align with a more clinical role, I fear expansion of scope, such as prescribing for minor ailments, can only lead to pharmacist burnout, fragmented and inconsistent implementation, and overall no significant benefit to relieving burden on the healthcare system or improving public health.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 416-948-3283
  • member of the public - POSTED May 2, 2020

    I am aware of the extensive ongoing training and knowledge required to be a pharmacist. I frequently ask my pharmacist’s opinion and totally agree this would be a win win for the public.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 2, 2020

    I trust my pharmacist more than my doctor where drugs are concerned. He is always available — unlike my doctor — to answer questions about medications I am taking.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 7056455053
  • member of the public - POSTED May 4, 2020

    Our health system is in need of assistance. Any viable solutions should be considered. Pharmacists are highly educated and capable of taking some of the load off hospitals and doctors for minor conditions.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 4, 2020

    I am a senior citizen with low income. I am concerned about the extra cost. I understand it is $15.00 per Rd. No much for me.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 226 384 1666
  • pharmacy assistant - POSTED May 5, 2020

    As a Pharmacy Student and currently working as a Pharmacy Assistant, I support the proposed expanded scope. Pharmacists are extensively trained during their schooling and are more than equipped to diagnose and prescribe for minor ailments. This serves to open up space in the healthcare system and reduce patient travel to several sites before accessing their medication. This change however, should occur with the workload of pharmacists and pharmacy staff in mind.

    YOU ARE A : Pharmacy Assistant
    ON BEHALF OF : Myself
    Phone Number (optional) : 6479290404
  • pharmacist - POSTED May 5, 2020

    I would only support an expansion of scope if pharmacists are to be fairly remunerated for their services. Pharmacists have already been taking on more duties with an increased workload without a pay increase.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : SDM
  • applicant - POSTED May 5, 2020

    I am a student at the Leslie Dan Faculty of Pharmacy. I wholeheartedly agree with the proposed expanding of scope of Practice, involving prescribing for minor ailments. The above ailments listed all seem reasonable and agreeable in terms of effectively being able to diagnose, prescribe and monitor these conditions from a pharmacy setting. Pharmacists have vast medical knowledge and are well equipped to prescribe. This is a great step for pharmacists and the profession in general!

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
    Phone Number (optional) : 4163021372
  • applicant - POSTED May 5, 2020

    I am in strong support of minor ailments prescribing with the proper safeguards in place to ensure that it is done safely and effectively. Like physicians, pharmacists should be able to bill for all consultations, and should not be limited to billing for those which result in a prescription. There also needs to be a predetermined schedule for compensation, along with support for how individual pharmacists will be compensated for taking on additional workload and liability vs. pharmacies. Continuing professional education is also paramount to ensuring that all pharmacists wishing to take this on are practicing to up-to-date standards. Finally, I believe that the College needs to support pharmacists in how this can feasibly be implemented in terms of how it will impact dispensing workflow, and reasonable expectations for dispensing once this is implemented. I do not feel that without this, it will necessarily be safely implemented in all practice settings.

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
  • applicant - POSTED May 6, 2020

    I am a third year student of the Faculty of Pharmacy, and having undergone the the curriculum, I can give an informed opinion. I am not sure as to what previous pharmacists covered in their curriculum in the past, but I can give my opinion on the education happening now. We are honestly educated more than we ever need to apply in practice. While this is a step is the right direction, I believe that pharmacists are able to provide much more benefit to the general public than with the proposed list. In school, we are taught pharmacotherapy but we are also taught to assess and treat other conditions, through dermatology, minor ailments (the course) and interspersed topics throughout the pharmacotherapy courses. The entire minor ailments condition list consists of 32 conditions, but I propose pharmacists can do even more. For example, we are taught diaper dermatitis, Seborrheic Dermatitis, Atopic dermatitis, Plantar warts, Onychomycosis, Scabies, Burns, Emergency contraception… etc. While this is not an exhaustive list by any means, these topics are covered throughout all pharmacy school, Some of these are covered by the full list of minor ailment conditions, but some are not. This only speaks to the wealth of information that a pharmacist contains. Allowing pharmacists to assess (not diagnose) will alleviate the pressure on the medical system, which is even more true during this pandemic. This will give doctors more time to deal with more complex patients, give patients faster care without the wait and give pharmacists the additional capability to give cognitive services. However, this potential benefit could be further improved upon my expanding this list and allowing pharmacists to do even more. It is reasonable that Ontario goes with a conservative list of conditions in the beginning due to the size of its population. This change is in the correct direction, but it is nonetheless should be stressed that pharmacists are capable of doing more for the health of the population, and still have untapped potential.

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
    Phone Number (optional) : 4164004034
    Organization name : Leslie Dan Faculty of Pharmacy
  • member of the public - POSTED May 6, 2020

    It is my opinion that a pharmacist knows as much, possibly more about prescribing drugs than many doctors. You allow nurse practitioners to prescribe drugs, surely a pharmacist can do it just as efficiently.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 7, 2020

    I hope there would be a short course that OCP could prepare to have pharmacists take (similar to courses for cannabis that we did prior to implementation) in order to prepare for this. Even streamlined approach in assessment and diagnosis would be very helpful to ensure an easier way for us to do this and to ensure a more accurate assessment. We are all used to diagnosing minor ailments (those found in CTMA) and there’s an approach to do that. Hopefully, we can come up with something for this new list that we will be dealing with in the future.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED May 7, 2020

    Great idea. Many times I know what is wrong. From previous ailments. Just need a prescription

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 5194435222
  • pharmacist - POSTED May 7, 2020

    With the current issues surrounding mental health, burnout, and the ever-increasing workload of the modern Pharmacist, adding yet another uncompensated act to our scope of practice will undoubtedly result in compromised care in other aspects. Pharmacists are already expected to work with no breaks, barely enough time to perform what is already required of us with an expectation of 100% accuracy, and resolve every situation ranging from clinical to administrative once. With no addition revenue for pharmacy owners, where is additional staff coming from to support the pharmacist in taking on this new chapter of professional practice? In the interest of the safety of the public, even more responsibilities than now will undoubtedly result in a plethora of pharmaceutical errors unless work or staffing issues are first addressed.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 6472157854
  • pharmacist - POSTED May 7, 2020

    I definitely think it is a right step in right direction. In this area Alberta is leading by the example. I am in 100% favor of this. Please also make sure that we are able to bill govt for our consultations coz if that is not done then it would be of no use in my opinion. I often refer patients to Emergency dept just for bladder infections coz they can see their dr in 3 days plus they need to take day off work to see the dr unfortunately. Timely access to health care is not luxury it is rather a necessity in my humble opinion. The list of medications should be expanded with including more and more conditions try to match up with what is Alberta’s level but same like Alberta there should be additional learning needed if advance prescribing authority comes in.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 7, 2020

    Wondering why proton pump inhibitors are not on the list for GERD even though they are available in small quantities as OTC meds.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 4168342762
  • pharmacist - POSTED May 8, 2020

    I am a doctor of pharmacy graduate and have been working in community pharmacy for the last three years. My experience in pharmacy however is lifelong; I have grown up within the “pharmacy environment” as the fifth generation of pharmacists in my family. I will support prescribing for minor ailments as a pharmacist only if (1) as a profession, we are added to the RHPA list of professionals who can call themselves a doctor (for those with PharmD credentials) since we have the medical training and will be acting as prescribers; (2) we are shown that we are valued by the health care system (eg declared frontline healthcare workers during this pandemic would be a start); (3) we are reimbursed equitably in comparison to the same service offered by other health professionals, as this will still benefit the health system and improve treatment access for patients; and (4) we are reimbursed per assessment, not per prescription written. Throughout the years, it has been evident how much the profession of pharmacy has changed. No longer do we “dispense as written” – we are now the clinical experts of medication. Just as a cardiologist is a heart specialist, we are the drug specialists. We know the doses, indications, appropriate durations, efficacy, interactions, and side effects of medication. We know what happens to a drug when it enters the body, how it is distributed throughout the body, how it is broken down and eliminated from the body. We know comparative effectiveness and safety for medications within and between drug classes when treating a specific medical condition. Not only do we know all this about medication, but at the same time we were also trained on the signs and symptoms of diagnosis for the issues that these medications treat (but not how to physically diagnose a condition, as this is the expertise of physicians). We are, in all senses, doctors of pharmacy – medication specialists. We evaluate every prescription with all these clinical elements in mind, in addition to appropriateness for a specific patient based on their age, conditions, other medications, allergies, body functions (eg kidney function), and likelihood of therapeutic success. For these reasons, I know as a profession we are more than capable of assessing and prescribing for minor ailments, and capable of prescribing for much more than is listed on the above proposed list. HOWEVER, I am currently AGAINST expanding our scope to prescribe for minor ailments for the following reasons. If these issues are addressed, I would gladly support prescribing for minor ailments: 1. Those of us with a Doctor of Pharmacy degree are not allowed to call ourselves “doctors” as described in the Registered Health Professions Act. We should not be excluded from this list if we have the credentials. I would like to point out that dentists and optometrists are allowed to call themselves doctors, yet receive very little medical eduction on the functioning of the entire human body in comparison, and even less on medication. Another example is naturopaths, who study pseudoscientific alternative medicine yet are able to call themselves doctors to the public. Doctors of Pharmacy have extremely rigorous medical training and deserve to be recognized on this list. We are medication experts. We should be treated with the same respect and recognition as these colleagues if we are to be prescribing and writing prescriptions for patients. 2. For decades, issues within the health care system have landed on the backs of pharmacists. We are the frontline of healthcare – there is no other medical professional you can pick up the telephone and speak to in a matter of minutes. This is something I am very proud of as a pharmacist, but being the most accessible comes with a huge responsibility that is often taken for granted by patients, the public, and even the government. We currently provide a wealth of services to the public for free and without charge, in a time when our professional service fee (dispensing fee) has not increased with inflation. Many doctors charge patients per visit, per rx renewal request, per fax, for copies of medical records, or for any extra services; we do not charge patients to speak to a pharmacist over the phone or in person, to fax an rx request to their doctor, for any paperwork such as medical histories or tax receipts, or to call their insurance company to straighten out coverage, among other services. We now provide flu shots in a more convenient manner to patients at a fraction of what physicians are given, while providing this service adds stress and chaos to the current busy workflow of dispensing prescriptions, answering phone calls, discussing OTC options with patients, compounding, counselling, and communicating with physicians. It is wrong that our time is not valued as much as other health workers who provide the same service (eg flu shot), yet we provide it in an even more convenient manner for the patient. 3. The current COVID pandemic has illustrated how essential pharmacies are to the Canadian health care system, yet also how undervalued our services are. We were not provided with any PPE supply and left to fend for ourselves, doing more with less, while maintaining the integrity of the health care system as we keep patients away from the emergency departments by renewing prescriptions and making recommendations in light of clinic and doctor office closures. It has taught me that we MUST be shown by the public and by the government of Canada that we are appreciated, before we agree to take on any further tasks that increase our workload without compensation. 4. For these reasons, any further increase in expanded scope needs to be remunerated fairly. Fairly means that as a health care professional, we are paid for our services the same fee that any other health care professional is being paid for that same service. Just because we are more accessible to the patient does not mean our service has the right to be valued any less – in fact, the convenience makes it more valuable to the patient. Paying us the same as a physician for a patient assessment is still beneficial to the healthcare system as a whole because it will reduce emergency room visits, physician visits, and walk in clinic visits as well as wait times for more minor issues, while those physicians can direct their expertise to more serious matters. This form of reimbursement is also necessary in order for us to take the time required to make an appropriate and thorough assessment. If a pharmacist takes 20 minutes with one minor ailment patient, the whole workflow – phone questions, doctor verbals, rx dispensing, and counselling – is halted, and it is not feasible for pharmacies to operate without appropriate compensation for this. We cannot provide safe care to patients if we run a deficit from time spent prescribing for minor ailments. 5. In order for any reimbursement model to work and to avoid any conflict of interest between writing a prescription or not, each assessment should be reimbursed, regardless if a prescription was issued. I propose each pharmacist receive a billing number similar to physicians in order to accommodate this reimbursement model. In summary, I will only support prescribing for minor ailments as a pharmacist if we are added to the RHPA list of professionals who can call themselves a doctor (for those with a doctorate, PharmD); we are shown that we are valued by the health care system; we are reimbursed the same as other professionals for this assessment and prescribing service; and we are reimbursed per assessment, regardless if a prescription is written. Thank you for your support.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • Other - POSTED May 8, 2020

    I’m very supportive of this expansion of a pharmacist’s scope of practice.. I’ve had the same independent pharmacist for several years – he knows me very well and also knows my family physician. Each year he schedules a meeting with me to review and discuss both my medications and any supplements I’m taking. He’s a key part of my health team and I totally trust his judgment. His colleagues at his pharmacy also know me very well.

  • member of the public - POSTED May 8, 2020

    Pharmacists are experts in pharmacology, and are definitely better versed in this than most clinicians who prescribe. However, I do not believe that they should be diagnosing. Even “minor ailments” are often part of a much larger clinical picture–For example, something that resembles candidiasis, an apthuous ulcer or herpes labialis can actually be oral cancer, in rare cases. Some “minor conditions” can be a sign of something more serious that could be missed if pharmacists are only treating symptoms at patients’ request. Pharmacists can’t be expected to have the clinical expertise across all areas of medicine, dentistry and veterinary sciences that would allow them to diagnose across every discipline. Some meds are not available OTC because of the risk of a wrong self-diagnosis. Having said that, I support pharmacists being able to prescribe for a pre-existing diagnosis, providing there is follow-up and ongoing assessment. For many conditions, I would be comfortable with communicating a diagnosis to a pharmacist and allowing them to implement a treatment course as they see fit, and they would likely be more effective in doing so than clinicians with limited knowledge of pharmacology who use a “recipe book” approach to prescribing.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • Other - POSTED May 8, 2020

    I am concerned about two items on this list. Namely, antibiotics for UTIs and hemorrhoidal treatment. Unfortunately antibiotics are already over-prescribed, especially in the elderly with nonspecific complaints and in women with chronic non bacterial interstitial cystitis. Multi-antibiotic resistant organisms are a real threat to public health. With respect to hemorrhoids, it is impossible to rule out a colorectal cancer as the cause of rectal bleeding without a physical exam (including a digital rectal exam) and further diagnostic testing in the right context. Respectfully, these are out of the scope of pharmacists.

  • other - POSTED May 9, 2020

    This is long overdue. More than 30 years ago I was in Florida with my one and a half year old son who was suffering from an ear infection. As this was my second child I was a nurse I was well aware of the drill. Go to emerge or your family doctor. They say Yes, he has an ear infection and here are your first line of defence antibiotics. Bring him back if antibiotics are not effective. In Florida I found out this was handled by the pharmacist!! Great!! No appointment necessary! No trip to emerge.necessary.. WOW!!!! This happened 30 years ago! Our country had better play catch-up and fast! Long overdue!!! Our health care system is good but it could be so much more efficient. By the way, the same pharmacist assisted me with a bad sunburn that blistered. On myself not my child! He managed the pain and the healing process. Today we are able to take our own temperatures, pulse, blood pressure, 02 sats, blood sugar levels etc. Most of us know this info before we even get to a doctor. It is time we utilized the pharmacist to their full potential!

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Phone Number (optional) : 7057909203
  • other - POSTED May 9, 2020

    I read with interest the comments from pharmacists. When reading the material the first thought that came to my mind was will they be compensated for the time required to thoroughly assess a client for a prescription? The second question that came to mind was will the pharmacy be influenced by drug companies to prescribe a particular medication? There have been articles in the past about influence and kick backs from drug manufacturers to promote their product. The third question is will there be continuity of service in large “drug stores” that are serviced by multiple pharmacists who sometimes provide differing information and are often working at more than one site. A patient is usually well known by their physician or the clinic they attend. When large corporately owned pharmacies became the norm with multiple pharmacists I have never had a personal relationship with any pharmacist. As a retired registered nurse having worked with pharmacists as a manager in retirement/long term care settings, I support the recommendations. While I can see the advantages of the recommendations I would advise the College to listen to the valid concerns of their members.

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Phone Number (optional) : 519-842-7851
    Organization name : CAG
  • member of the public - POSTED May 10, 2020

    This is a wonderful idea in my opinion. Pharmacists are extremely knowledgeable and I think capable of prescribing in these cases. ESPECIALLY When one has moved to a small town and no doctors are taking any more patients! I have to drive 1.5 hours to see my prior doctor. I hope this comes to pass!

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 905-632-8457
  • member of the public - POSTED May 11, 2020

    I believe Pharmacists should be able to prescribe for minor ailments and conditions that are not complicated. They have more experience with drugs and a better understanding of how drugs work for certain conditions.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 14166164630
  • member of the public - POSTED May 12, 2020

    This is very concerning. Many of these conditions require a physical examination to be properly diagnosed. I am not in support of this as it is a threat to public safety.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 12, 2020

    I am concerned you will be missing rectal cancer by starting to treat hemorrhoids without proper examination. Will you be referring for colonoscopy and following up? Do you have the time to do a full respiratory exam along with the viral conjunctivitis? To risk stratify? Often they present with URTI symptoms. Are you taught how to do that? What about checking for elevated intraocular pressure which can mask as viral conjunctivitis? Have you been trained to recognize UTI from bladder cancer, overactive bladder, kidney stones? Will you be ordering tests to differentiate or just treating everybody with antibiotics. There are risks to the public when we try to simplify medicine.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 12, 2020

    This is the best news I have heard recently. It is a wonderful idea to not stress the healthcare system. Pharmacists are capable of these diagnosis and treatments. Thank you

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 12, 2020

    To whom it may concern, I support expanding pharmacist role to prescribe minor ailment medication. As a patient, wait time is huge for doctors, and not worth the time given a simple flu is observed by myself for example. The doctor won’t do anything more than listen to heart beat, ask how I’m feeling then prescribe the medication I know I should be getting. Have a pharmacist be able to do that would reduce wait times MASSIVELY, reducing load on doctors and increasing time efficiency for patients. Please allow pharmacists to be able to prescribe minor conditions medication.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 6477676253
  • member of the public - POSTED May 12, 2020

    Pharmacists are already overworked, and now during this pandemic they have become a first point of contact for all those individuals scared to go to their doctors’ office. I think this is a great idea but now is not the time. First get this crisis under control and make sure there is accountability in place, and enough technician support is available if they are to take on these added responsibility. .

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 519-221-7420
  • member of the public - POSTED May 12, 2020

    It totally makes sense that pharmacists be able to prescribe for the types of issues listed. That saves countless hours of patient time, waiting to see their doctor for something that could be handled by the pharmacist. Doctors will be able to hopefully devote more time to patients with other needs. The only issue I wonder about is whether the pharmacists will have extra pharmacy assistants, as I imagine they will be needed. I’d much rather be able to go to my pharmacist than have to wait to see my doctor. I do hope this comes to pass.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 12, 2020

    I feel strongly that pharmacist should be given the authority to prescribe for minor ailments mentioned above. Upon finishing the course offered by OPA. I feel i an now more qualified to prescribe than before This should also be a mandatory requirement for pharmacist licence renewal. For all Ontario pharmacist

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 519-746-4500
    Organization name : Student Health Pharmacy
  • member of the public - POSTED May 12, 2020

    No I don’t agree with all of these proposed changes. This change can further fragment care. There is a conflict of interest when one discipline diagnoses, orders, dispenses and sells, for profit, medications to the public. If the pharmacists are not diagnosing then how can they determine the course of action? I can identify several conditions on the list that could warrant further discussion with the patient about other health concerns of which the patients may not want to discuss in a pharmacy. As well, how many UTIs will a person be treated for before the PCP be notified? When does the patient get referred back to their PCP? What happens to those patients who pharmacy shop? How are the vaccine records going to be transferred to the PCP office or to public health records to ensure their record is kept up to date? Pharmacists have complained about being over worked so how will these changes reduce their workload?

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 12, 2020

    I worry about the expanding scope and potential consequences. For example: 1) Urinary tract infections. There is risk of over prescribing of antibiotics (and potential development of antibiotics resistance). How would pharmacists rule out pyelonephritis? How would pharmacists obtain urine cultures to ensure appropriate follow-up in case UTI is resistant to antibiotic used? 2) conjunctivitis: red eye is a common presentation. However, there are several important diagnoses that should be ruled out. For example, there are a number of red flags that should be evaluated (reduction in visual acuity, photophobia, severe foreign body sensation, and concerns about glaucoma). How would a pharmacist at a busy location be able to evaluate for these signs ? 3) Hemorrhoids: how would this be examined to rule out rectal cancer? Would there be a referral for colonoscopy? Would there be an opportunity to arrange for follow up? 4) Insect bites: how would an examination be conducted if the bite is in a sensitive area? Would this be prescribed without an examination? How would the pharmacist evaluate for Lyme disease? 5) Oral thrush: this could be a sign of HIV. Would pharmacists order tests to rule this out and follow up? My concern is that although many of these presentations are common and straightforward, there are potentially red flags that could be missed if there is no exam done or if no proper evaluation is conducted. This can be dangerous for patients when there is a misdiagnosis or delay in correct diagnosis. In addition to the above, I am concerned about the real conflict of interest in that pharmacists would be both prescribers and dispensers of meditation. This can be challenging and can potentially erode the trust of the public in the profession. We have a strong publicly funded health care system in Ontario with access to family doctors, walk-in, and emergency departments. Expanding this role for pharmacists can jeopardize the safety of patients who put their trusts in their pharmacists. I hope you consider this feedback and implement changes that put the safety of the public first.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 12, 2020

    I don’t think this is a good idea overall. How will my pharmacist know if I have a UTI (not an STI) and hemorrhoids (not worms or rectal prolapse). I can’t see them examining me. Keep Ontarians safe.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 13, 2020

    I have a few concerns regarding the proposed changes: I do not believe that medications can be renewed for one year without any monitoring of the person’s health status. . I see a potential conflict of interest when the same person diagnoses, prescribes, dispenses and sells the med for profit. How are the vaccine records updated? Will a record be sent to the family doctor’s office or to the local public health unit ? What about the patients who pharmacy shop? How will they be managed? I do not agree with the treatment of minor ailments re: urinary tract infection without the capability of doing a urinalysis and ruling out other differential diagnosis such as pregnancy, interstitial cystitis, atrophic vaginitis. Over-prescribing of antibiotics and antibiotic resistance is a health care concern that can only be fought by the ability to have the time and ressources to do a thorough history and physical assessment. Patient safety is at risk if prescribing anti-inflammatories without knowledge of the patient’s eGFR I do agree that pharmacists need to be remunerated for performing these additional acts, whether it be by direct billing or increase in salary. The caveat to this is that they will have less time for pharmacy related duties re: dispensing, doctor phone calls, telephone orders – which will significantly increase the wait time of other customers at the pharmacy.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 13, 2020

    Minor Ailment Prescribing can help reduce emergency or urgent care visits especially in small towns where there are no walk inn clinics. Less exposure to more serious, sick people in the hospital and clinic waiting rooms etc. Saves time for patients and the doctors. Encourages people to get assessed by the pharmacist rather than self medicating in order to avoid clinic/ hospital visits.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : Rx Drug Mart
  • pharmacist - POSTED May 13, 2020

    I completed the OCP minor ailment management course earlier this year and found the expected knowledge level completely unreasonable. There is no way any pharmacist would be able to take on that amount of information and use it. I found the format very frustrating and not helpful. I appreciate that pharmacists are ideally positioned to help reduce the work load of family doctors and to provide care in under serviced areas but it will not come without additional administration and infra structure costs. Flu shots are a great example of what services pharmacists can provide but they also illustrate the huge amount of administration associated with same ie. filling out forms and reporting the action to the patients doctor. Also,$7.50 barely covers the overheads. (injection material, sharps destruction, bandaids etc) No additional hours are given to most pharmacist to perform these duties. In order to avoid errors and pharmacist burn out, adequate reimbursement is essential. Already overburdened pharmacists need to be given the means to provide these additional services, ie additional pharmacist hours and that would mean adequate compensation. I also imagine when there is a COVID vaccine, the pharmamcists will be considered a primary provider . This in addition to the flu shots and any other programs that are being implemented. I am also concerned that there will be additional pressure put on the pharmacist by customers whose expectation is that the pharmacist will diagnose and treat their problems. Its bad enough now with patients allowing their prescriptions to run out with the expectation is that the pharmacist will authorize a repeat automatically. In short a great idea but the government must provide adequate reimbursement and make the system user friendly. Reduce the paper work!!!!!

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : Rx Drug Mart
  • pharmacy assistant - POSTED May 13, 2020

    I think that aiding front-line workers with flu shots and diagnosis is essential. However, providing proper and safe sources to do so is as needed. I would find the amount of paper work/administrative duties difficult to give quality attention to already very frustrated patients, especially when a 3 months supply of medication is resumed. There has been some initiative for financial compensation, I would like to see this to be extended given all the extra work that will be expected.

    YOU ARE A : Pharmacy Assistant
    ON BEHALF OF : Myself
  • other - POSTED May 13, 2020

    Pharmacists and doctors should (and do) work together. Neither can function well in isolation. If doctors prescribe without the consulting support of pharmacists, they will likely make less effective or more dangerous choices. If pharmacists treat without a physician’s expertise in diagnosis/ruling out other issues, they will likely delay effective treatments (sometimes with disastrous outcomes). Your goal ought to be integration of the various expertises, not trying to have one profession make do without another.

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • member of the public - POSTED May 14, 2020

    I agree. Pharmacists are more knowledgeable about medication than most M.D.s.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 15198562267
  • member of the public - POSTED May 14, 2020

    I think this initiative is moving the role of pharmacists in the right direction. However, there needs to be an expansion on the prescription of antibiotics. For example, many individuals experience styes of the eye and require antibiotics.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 14, 2020

    This is the feedback I posted (please consider adding your feedback too): I worry about the expanding scope and potential consequences. For example: 1) Urinary tract infections. There is risk of over prescribing of antibiotics (and potential development of antibiotics resistance). How would pharmacists rule out pyelonephritis? How would pharmacists obtain urine cultures to ensure appropriate follow-up in case UTI is resistant to antibiotic used? 2) conjunctivitis: red eye is a common presentation. However, there are several important diagnoses that should be ruled out. For example, there are a number of red flags that should be evaluated (reduction in visual acuity, photophobia, severe foreign body sensation, and concerns about glaucoma). How would a pharmacist at a busy location be able to evaluate for these signs ? 3) Hemorrhoids: how would this be examined to rule out rectal cancer? Would there be a referral for colonoscopy? Would there be an opportunity to arrange for follow up? 4) Insect bites: how would an examination be conducted if the bite is in a sensitive area? Would this be prescribed without an examination? How would the pharmacist evaluate for Lyme disease? 5) Oral thrush: this could be a sign of HIV. Would pharmacists order tests to rule this out and follow up? My concern is that although many of these presentations are common and straightforward, there are potentially red flags that could be missed if there is no exam done or if no proper evaluation is conducted. This can be dangerous for patients when there is a misdiagnosis or delay in correct diagnosis. In addition to the above, I am concerned about the real conflict of interest in that pharmacists would be both prescribers and dispensers of meditation. This can be challenging and can potentially erode the trust of the public in the profession. We have a strong publicly funded health care system in Ontario with access to family doctors, walk-in, and emergency departments. Expanding this role for pharmacists can jeopardize the safety of patients who put their trusts in their pharmacists. I hope you consider this feedback and implement changes that put the safety of the public first.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 2262372499
  • other - POSTED May 15, 2020

    I do not think this is a good idea. Speaking as a physician this feels like a bad call in terms of risk of antibiotic resistance, treating unnecessary infections and inappropriate long term use. I think that although our pharmacist colleagues are brilliant and experts in pharmacology, diagnostics and history assessments are not necessarily within their scope of practice.

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • member of the public - POSTED May 15, 2020

    A wise move as pharmacists in Canada are scientifically qualified to deal with such cases and it is also more accessible to the patient and less costly to the government in terms of health expenses, of course with clear and strict instruction, strongly agreed.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 2899412324
  • member of the public - POSTED May 15, 2020

    I think that this would be great! I’ve had to wait quite a while in my doctor’s office and walk-in clinic three or 4 times this year for a 2 minute visit for two of these 12 ailments.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 15, 2020

    While the list may be small, it seems uniquely better compared to NS, where I previously worked. Many items on their the NS were solidly in the OTC recommendation category and didn’t change practice at all. This looks great!

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 15, 2020

    The use of AHFS criteria is an interesting approach to ensure Pharmacists are prescribing appropriate drugs for the minor ailments OCP has proposed. However, I think that there may be unintended consequences from the use of AHFS criteria. 1) As new medications are developed and approved for use, there is a significant lag time before they are categorized into specific AHFS criteria. This may limit the ability of patients to access an appropriate medication via their Pharmacist for no reason other than bureaucratic delay. I would suggest OCP consider a model more similar to Alberta whereby Pharmacists are limited to prescribing medications that have a Health Canada indication for the relevant minor ailment. This ensures that Pharmacists are prescribing appropriately and also that Patients are not denied access to medication. 2) It is not intuitive what medications are in a specific AHFS criteria and thus pharmacists will have to consult the list each time. This may limit the effectiveness of a Pharmacist consultation. For example, A Pharmacist is may do a minor ailment consultation and using their professional judgement determine that they should treat the Patient’s allergic rhinitis with an oral antihistamine given their signs and symptoms and past medical history, If the Patient has used an oral antihistamine in the past for similar symptoms, it may be preferred by the patient to utilize the same therapy. However, upon consultation of the AHFS criteria, the Pharmacist will find that they are not permitted to prescribe oral antihistamines. This will result in patient frustration with the system as well as inefficient in the Pharmacist ability to provide patient care. By having the ability to prescribe appropriate therapy in their professional judgement, this will allow Pharmacists to more effectively provide necessary care for their Patients. If there is a specific concern about prescribing certain medications e.g. contributing to pseudomonas resistance due to inappropriate prescribing of ciprofloxacin for UTIs, I think a more effective way is to indicate that in the regulations. Specifically, ciprofloxacin may only be prescribed in cases on allergy/intolerance to other first line treatments for uncomplicated UTIs. Overall, I find the process to be more cumbersome and complicated than it needs to be. It is not designed in a way to fit seamlessly into the existing Pharmacy workflow. I understand that a great deal of caution and attention to Patient safety must be taken but the goal should be to create a system that enables greater access to care. In the proposal, I do believe that a sizable portion of the potential Patient population will become frustrated with the limitations outlined above and return to their physician for treatment of these minor ailment conditions. In the example above regarding an allergic rhinitis patient, I do not believe that the exclusion of oral antihistamines would prove to reduce the likelihood of harm to a patient. If anything, the Patient would be required to seek another consultation from a Primary Care Provider, further delaying their access to timely care. In urban centers, this may not prove to be difficult. In remote areas of the province where Primary Care Providers are not readily available during evenings or weekends, this significantly increases the delay in access to care. This effectively creates two tiers of Patients. Those who can rely on the availability of a Primary Care Provider if their Pharmacists are not permitted to prescribe appropriate medications, and those who do not. The regulations must be drafted in a way that is effective for all Ontarians and not just those in urban centers.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED May 15, 2020

    I am happy about the expanded scope of practice, but I am worried at the same time. How will you ensure that a retailer like Rexall famous for it’s imposed quotas on Medschecks will not be doing the same in that case? One thing is a poorly done Medscheck and a completely different thing is an inappropriately prescribed treatment under corporate pressure for more$. What will you do to protect the public against it?

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 15, 2020

    Would be convenient to get help at the pharmacy. Not sure I understand the AHFS stuff. Just want to get help from pharmacy for simple stuff. In Nova Scotia where I recently moved from this was common. Glad Ontario is catching up

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 15, 2020

    I support the proposal authorizing Ontario pharmacists to prescribe medication for the common, minor ailments described. Let’s help streamline healthcare. This would allow quicker treatment of these ailments since patients often need to wait 3-4 days for a doctors appointment. Pharmacists are available for many hours in the day, and evenings,too. It just makes good sense to expand their prescribing ability. After adequate training, of course!

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • other - POSTED May 17, 2020

    Hello, I believe that this is a step in the right direction. Pharmacists are healthcare professionals and are the drug experts. They go through extensive training and would easily be able to effectively prescribe for minor ailments. I would have liked to see the ability of ordering lab tests coming along the minor ailments prescribing. In some cases, ordering lab tests might be necessary to help the pharmacist make an informed decision on what is best for the patient. This move forward does not only help the patients but help our healthcare system that is deeply in need of assistance. Pharmacists have the potential and the education to practice and help other healthcare professionals. Expanding pharmacists’ scope of practice will help alleviate the stress on our system. I really hope that the list will only grow bigger and the scope for pharmacists keeps on getting expanded. I also hope that pharmacists will be recognized for the work they are doing and that they will get compensated for this professional service they will be providing.

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 18, 2020

    I think the list should include all what is allowed by other provinces. Saskatchewan, Alberta. We are so behind in Ontario. This is impacting the level of healthcare that Ontarians receive. Thank you

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • applicant - POSTED May 18, 2020

    As a first-year Student Pharmacist at the University of Waterloo’s School of Pharmacy, I am extremely excited about these upcoming changes to expand our profession’s scope of practice. Even now, I am receiving education on the current list of minor ailments and cannot wait to be able to utilize my knowledge and prescribe medication to my future patients. I wholeheartedly support this change in the legislature and am hoping we see more minor ailments added in the future.

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
    Organization name : University of Waterloo
  • pharmacist - POSTED May 18, 2020

    Prior to the present COVID-19 pandemic, there has been ongoing advocacy for expanded scope of Ontario pharmacists. Interestingly, many other Canadian provinces such as British Columbia and Alberta already have this expanded scope in place so why hasn’t this already been considered by Ontario? Being able to prescribe for minor ailments serves to optimize patients’ quality care and their overall health and well-being without them having to encounter reactive medicine and in having them experience long wait times at their family physicians’ office or hospitals. Pharmacists are easily and widely accessible to the general public within the community and have been reported to be the number one most trusted clinician compared to many other health care professionals. In addition, no other professional healthcare program studies pharmacokinetics and pharmacodynamics of drugs in as much detail as pharmacists have, which is essential to understand given that everyone reacts to medications differently, whether they’re completely healthy or not. As a result, I hope the government gains greater confidence and peace of mind in knowing pharmacists’ are well-equipped in prescribing for minor ailments and will be a highly valuable and proactive measure that’ll benefit the healthcare system. Moreover, by having pharmacists being able to prescribe for minor ailments it helps with addressing financial costs and reducing hospital and physician workloads so they can focus on more acute and/or severe conditions. However, with all this said, it should be noted that there needs to be consideration into fair compensation and public education since pharmacists are already managing their demanding responsibilities as therapeutic safeguards to patient health and because the public often misunderstands pharmacists’ role as just “pill counters”. We appreciate and thank the government for collaborating with us in this effort to help enhance public health and hope this will result in something that helps foster upon improving and developing upon our current healthcare system.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : University of Waterloo
  • pharmacist - POSTED May 18, 2020

    I strongly support this expansion .It is time for the pharmacists to step up as most accessible health care professionals for the public convenience,particularly after an obvious role has emerged during the situation of COVID-19 pandemic.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 18, 2020

    I support this expansion and think it’s an extremely important step to ease the healthcare burden on primary care workers and be an accessible form of healthcare to patients. It would be even more beneficial to incentivize pharmacists with reimbursement for continuing education or other compensation for professional services!

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED May 18, 2020

    I support minor ailment prescribing for pharmacists. I don’t have to wait at the doctors anymore and pharmacists can help ease the healthcare burden!

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 18, 2020

    I support minor ailment prescribing, I think us new graduates have received adequate training and are thoroughly prepared for this. However, I also support being adequately compensated for our efforts. It would be unfair to ask us to do more work without fair compensation.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 6479618668
    Organization name : Waterloo Pharmacy
  • other - POSTED May 18, 2020

    I am a current student at the Waterloo School of Pharmacy. It is great to see these changes being implemented here in Ontario. We are learning about the rapidly expanding scope of practice and I am confident that pharmacist’s will be able to take on these extra responsibilities while helping the Canadian Healthcare System.

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Phone Number (optional) : 5195024606
    Organization name : Waterloo School of Pharmacy
  • member of the public - POSTED May 18, 2020

    I support minor ailments prescribing however they should be compensated adequately.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 6472999593
  • Other - POSTED May 18, 2020

    I strongly believe that Pharmacists have the necessary skills and knowledge to confidently prescribe for minor ailments and as such continue to contribute to and optimize their patients’ health! Pharmacists can do so much more for their patients, and the government should encourage and help them to do so!

  • Other - POSTED May 18, 2020

    Very excited to see this move forward and to put this into practice when I’m out of school to lessen the burden on the healthcare system!

  • pharmacist - POSTED May 18, 2020

    I know I speak on behalf of most of us PharmD students when I say that we feel confident in our minor ailments knowledge, to an extent where we should have the ability to prescribe for these conditions.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : University of Waterloo
  • pharmacist - POSTED May 18, 2020

    I see many comments from members of the public concerned about red flags being missed or disregarded. Speaking as a PharmD student, I can tell you that we spend countless hours in school learning red flags for each of these conditions. We are specifically taught what questions to ask patients in order to rule out more serious conditions (for example, how many times x has happened in the last x number of months). We are trained to know when it is appropriate to recommend a product, and when it is appropriate to refer a patient to a physician or emergency department. In terms of time, YES this would undoubtedly add on to pharmacists’ already busy workload. However, it would decrease the overall burden on our provincial healthcare system, since so many unnecessary clinic appointments would be avoided. Consider this very common, realistic occurrence that happens all the time in pharmacies: a young woman comes to the counter complaining of what she is certain is another UTI, since she has had them in the past and knows how they feel. She knows what worked for her in the past and what did not. The pharmacist asks her the relevant questions and determines that there are no red flags and her symptoms are consistent with a UTI, as she predicted. This woman has a few options: wait a few days in extreme discomfort to get in to see her physician; go to an emergency or walk-in clinic and wait a long time, no doubt adding to the clinic doctors’ heavy caseload; OR… receive and fill a prescription at that pharmacy for the very medication she would have been prescribed by her physician. Which option makes the most sense? What is in the best interest of not only Ontario patients, but the overall provincial healthcare system? For these many reasons, I believe pharmacists should have the ability to prescribe for minor ailments – at the very least pharmacists who have full doctorate degrees. ~ a current PharmD student who has high hopes for pharmacists’ scope of practice in the years to come

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED May 18, 2020

    I support pharmacists prescribing as long as they are properly paid for their services.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 6472910612
  • member of the public - POSTED May 18, 2020

    I support pharmacist prescribing and support them getting fair remuneration for this work.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 4163896739
  • pharmacy assistant - POSTED May 18, 2020

    I am in full support of expanding pharmacists’ scope. They are exceedingly knowledgeable and understanding of drug therapies. This will truly enhance the publics’ experience in receiving safe and appropriate care conveniently. In order to combat safety concerns, its necessary to understand that pharmacists have the essential education and would not be assessing patients superficially, furthermore, they are taught and able to advise patients to a physician when required. We’re aware how busy pharmacies can get and how much harder pharmacists have to work during those times, and so given the extra time allotted for patient assessment, there should be compensation for these services.

    YOU ARE A : Pharmacy Assistant
    ON BEHALF OF : Myself
  • member of the public - POSTED May 18, 2020

    Pharmacy students go through vigorous training and have the utmost expertise when it comes to medicine, that most doctors have to rely on when prescribing in the first place. When it comes to combinations of medicine, the first person that comes to mind for any prescribing doctor is an experienced pharmacist. My grandfather who has kidneys functioning at 15% has been saved by his pharmacist at the hospital when doctors were giving conflicting advice. I 100% support pharmacists prescribing minor ailments (that’s a no brainer in my opinion). I don’t understand why this is not already in place not only for minor ailments but major ailments as well. I see the decision making of doctors when prescribing for major ailments handed to pharmacists anyways and they sign off on it. So why is there even a question for minor ailments?

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 416-561-4098
  • pharmacist - POSTED May 18, 2020

    I am in full support with these propossls. I would also recommend additional prescribing privileges as others have mentioned. Pharmacists know much more about medications than any other healthcare profession. As well, pharmacists MUST be reimbursed for their work as other prescribers are.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 18, 2020

    I agree with the list of common ailments to start as proposed by OCP. Pharmacists are in a unique position to provide these kinds of assessments to alleviate the medical system and prevent patients from presenting to hospital ED. However, I can only support these recommendations if the college and government are willing to institute reasonable reimbursement for this service AND have requirements for adequate staffing that ensures assessments are done correctly. Pharmacists in many community settings are already being pushed to the brink with very heavy workloads of preparing prescriptions, providing professional services and consultations. Adding these new services without reimbursement nor ensuring additional staffing is unreasonable and increases risks to the public.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 18, 2020

    It is the right step in right direction and even overdue . I urge the college to expedite the process to reduce the burden on hospitals. Having said that, there at be proper compensation mechanism for pharmacist .

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • Other - POSTED May 18, 2020

    I am against pharmacists prescribing. We do not have the right work environment or reimbursement model to take on such responsibility and liability. It will add pressure to pharmacists responsibilities and jeopardize patient safety. We are already overworked and our working conditions are not optimal for patient safety. We don’t even get a proper lunch break to nourish ourselves and improve our focus. Let’s work on these “basics” before adding more to our plate. Adding this on is a huge liability, I support physicians and nurse practitioners prescribing, as they have the correct infrastructure to support such an activity.

  • member of the public - POSTED May 18, 2020

    I do not support this idea. There is a clear conflict of interest here, with the pharmacist diagnosing, prescribing and dispensing. As a member of the public, how do I know that they’re not pushing a prescription so that they can me the money associated with filling a prescription? I prefer that one person does the diagnosing and prescribing, while another independent individual does the therapeutic checking and the dispensing. I say this with all due respect to pharmacists, as I know many are knowledgeable in their field. My worry is more that larger corporations will use them as tools to increase their profits through pharmacists prescribing, and the patient and the pharmacists are the victims in this scenario.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 18, 2020

    Expanding our scope without providing strict guidelines on workload to pharmacy owners is a mistake. You’ve already made this mistake with injection services and meds checks which have allowed employers to institute quotas to the detriment of pharmaceutical care. What good is having a pharmacist assessing for these conditions if they don’t have adequate time to check and counsel on medications, which is the foundation of the profession? How are you serving the public good by expanding scope when we’ve still got dangerous workloads from your previous expansions of responsibility? Until you’re willing to step up and really protect the public by recognizing reasonable limits on workload for those actually practising the profession, you should be hesitant about adding new responsibilities that are going to be monetized and abused by those with only a financial interest in the practice of pharmacy.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 18, 2020

    I’m a third year pharmacy student and I believe we are prepared for this change. We really are the medication experts. The number of prescriptions received from doctors with incorrect treatments plans are shocking, because they use standardized treatment/care plans for all patients. Some physicians call us asking for recommendations because they are unaware of other treatment options… Hope to see this happening in the next few months.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 18, 2020

    Absolutely not. My company will force me to churn them out with quotas and the profession as a whole will create polypharmacy and overprescribing. Hello Trudeau government. Save your money. My job doesn’t need this headache

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • other - POSTED May 18, 2020

    I am a pharmacy student. This is a great draft list of regulations for minor ailments. Thank you for your work on this venture.

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Organization name : University of Toronto Faculty of Pharmacy
  • member of the public - POSTED May 18, 2020

    Strongly agree. Canadian Pharmacists are highly qualified for prescribing and also to reduce burden on government by reducing number of visits to Doctors

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 19, 2020

    Pharmacists should have prescribing rights. This will help dilute the volume of patients that are visiting doctors for the sole purpose of prescriptions, many of which happen to be on a repetitive basis. Pharmacists are well informed and trained in this field and should be given this accountability.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • Other - POSTED May 19, 2020

    I am a first year pharmacy student studying, while also participating in the Pharmacy students fighting against COVID19 group. I think that it is incredible that the pharmacist’s scope of practice is expanding and that pharmacists can prescribe medications for some minor ailments so that individuals can avoid waiting in hospitals or calling their physicians. I am very intrigued to see how this will keep expanding within the next few years and am proud to be part of such a promising field!

  • other - POSTED May 19, 2020

    As a pharmacy student, it is beyond exciting to see our scope expand in Ontario in order to reduce the burden on the health care system. Pharmacists are widely accessible and have so much to offer our patients!

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Organization name : University of Waterloo School of Pharmacy
  • other - POSTED May 19, 2020

    Currently a pharmacy student. Would love to see pharmacists practice to their full scope by the time we graduate and enter the field! It not only significantly decreases wait times and puts less pressure on clinics, but also helps build a stronger relationship between pharmacists and their patients!

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • member of the public - POSTED May 19, 2020

    This is long overdue. This will help many people by allowing more access to people who can prescribe medication. Glad to hear it’s finally getting done.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 4163051170
  • applicant - POSTED May 19, 2020

    I am a uWaterloo pharmacy student, and this is great idea! We learn so much about clinical conditions in school, it would be great to be able to use them in practice! I hope that some students can also be included in this conversation as they are the pharmacists of tomorrow and seen through PharmAgainstCovid19, students are capable of a lot!

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
    Organization name : PharmCovid19
  • other - POSTED May 20, 2020

    Minor ailment prescribing will help lower the healthcare burden on other sectors and will also help pharmacists expand their scope in what they do best; pharmacy education.

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Phone Number (optional) : 4166970898
    Organization name : University of Toronto
  • pharmacist - POSTED May 20, 2020

    Not in favor of expanded scope

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • member of the public - POSTED May 20, 2020

    I fully support expanding the scope of practice for pharmacists. This is especially relevant due to the fact that patients do not wish to visit Emergency Departments and often their own family doctor during this COVID-19 pandemic. When the regulations come into effect it will be essential to have clear, transparent communication with the public. For example, who are the members of the pharmacy team and what is each one permitted to do under these new regulations. It will also be essential to state that pharmacists have the training to provide these services (and that it is an established practice in other jurisdictions/countries). You have already been working closely with the public on this process so please do not stop when it comes to implementation.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • other - POSTED May 20, 2020

    As a pharmacy student, I support this step forward in expanding the scope of Ontario pharmacists. However I would like to stress that it should be implemented in a way that supports the pharmacist – adequate financial compensation, and a change in societal expectations of a pharmacist’s workflow. Pharmacists are definitely trained to provide this service however they must be recognized and supported (by both the government and the public) for this to be a success.

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • pharmacy assistant - POSTED May 20, 2020

    I think this legislation is long overdue and pharmacists are more than qualified to take on this responsibility. In turn this will have drastic impacts on our healthcare system by lowering the strain in emergency rooms and allowing those who need the most urgent care to get it in a timely manner. In addition it will save tons of time for distressed patients who have a minor ailment but cannot afford to wait in an ER or have access to a doctor right away.

    YOU ARE A : Pharmacy Assistant
    ON BEHALF OF : Myself
  • member of the public - POSTED May 20, 2020

    I support Pharmacists playing an active role in prescribing medications. This will help the healthcare system.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 20, 2020

    This is a bad idea. The timing could not be worse. We are not even being recognized as frontline healthcare workers during a pandemic, and now you expect patients and other prescribers to respect us as the newest prescribers in healthcare? Our image is painted as price gougers. This will add to that false argument. How about we get the basics right before we venture into this big project. How about we start by tackling improved working conditions for pharmacists, mandated lunch breaks to improve working human conditions and thereby improve patient safety? How do you expect me to work a 10-12 hour shift with no lunch break, check prescriptions, offer flu shots, provide OTC recommendations at any time and fast, speak to HCPs on the phone at any time they call or ask for my help with no pre-scheduled appointment, check blister packs, and now assess, diagnose, prescribe and appropriately follow up, all while not even stopping for a 15 minute lunch break? We are not machines. We are not donkeys. Stop adding to our workload. It is unreasonable. If you go to a dentist with a quick question, they will conduct a dental exam, and regardless of what the exam shows, they will charge you over $100 for the 5 minute consult. I am assuming that there is no reimbursement model for this for pharmacists? Enough is enough. Why should I be providing my knowledge and expertise that I have acquired through years and years of schooling and on the job learning with NO professional fee? If a physician even mentions smoking cessation during a patient consult, they are able to bill OHIP for that. How much more free advise can we be giving? When advice is given for free, it creates the perception that it is of low value. What other professional operates in this cheapened manner? OCP, if you care about patient safety, you should be protecting the profession and how services are conducted. It is not about quantity of services, but qualify and patient safety. An activity like prescribing will quickly turn into a quantified metric by big box district managers and the pharmacist will have to meet those quotas. There goes professionalism. The pharmacist has no leverage. I see many students on here enthusiastically, and respectfully I would add naively, supporting this initiative. As someone who has worked in the retail setting for a number of years now, I recommend you pause for a moment, take a good look around you, and smell the REAL roses, not the unrealistic ones your pharmacy schools are presenting you with.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 20, 2020

    This is welcomed significant development. Looking at the proposed scope, I feel that the proposed list could be expanded more. Pharmacists are the go to professional for majority of health needs and as such should be given more authority than the proposed list. Considering that Nurses are able to prescribe anything, our list of minor ailments should have covered more areas especially for practitioners with specific accreditation like CRE, CDE etc.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 9055319117
  • Other - POSTED May 21, 2020

    This expansion of minor aliments is a great change I believe and so pleased that this is coming to Ontario!

  • pharmacist - POSTED May 21, 2020

    Absolutely support pharmacists prescribing for minor ailments. The list should be expanded to include other conditions as observed in other jurisdictions such as travel health/vaccinations and hormonal contraception to help address patient access and improve health care. Restrictions related to treatment options make it challenging for Pharmacists to apply their deep knowledge in medications. There are patient factors/considerations that the pharmacist need to take into account which means their choice of therapy may not necessarily fall into the AFHS categories outlined. As with all services, if a Pharmacist is not comfortable with or feel they don’t have the competency – it is their responsibility to refer/get more training so there really is no need to be prescriptive. Public reimbursement is also critical – not only to support pharmacy service delivery but also to help reduce barriers to access (i.e. cost to the patient). Happy to see that Ontario pharmacists are given the opportunity to further contribute to the wellbeing of Canadians and help alleviate burden on the health system!

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • other - POSTED May 21, 2020

    It should be made compulsory that a pharmacist be the clients main provider of medications so that interactions and health history is known. As well, with each prescription provided to clients should be instructed that their primary care provider whether physician or Nurse practitioner will be notified of the new prescription being provided to them. Will the pharmacist be aware of renal clearance values prior to prescribing!

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • member of the public - POSTED May 21, 2020

    I trust my pharmacist, of course with collaboration with other health professionals they can play important role in term of treating minor alinments .

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • pharmacist - POSTED May 21, 2020

    In principle, this is a great initiative and necessary to improve access to health care for the public and provide pharmacists with an opportunity to meaningfully contribute to health outcomes. However, I think there are 3 prerequisites that must accompany this process: (1) Training and education opportunities for pharmacists (2) A guideline for reimbursement that is commensurate with the value being provided to the patient as well as be alleviated from the traditional health system, and (3) a process to ensure pharmacists who do not engage in education and professional development are not permitted to prescribe and be reimbursed for this service.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Organization name : PharmaSense Pharmacy
  • member of the public - POSTED May 21, 2020

    Pharmacists are extremely well trained and know their customers very well. Mine has noticed negative interactions between 2 drugs prescribed by two different specialists.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
    Phone Number (optional) : 7053246461
  • other - POSTED May 21, 2020

    Very happy to see this coming to Ontario – Pharmacy Student

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • other - POSTED May 21, 2020

    This response was submitted by Shoppers Drug Mart and Loblaw Pharmacies. Read the full submission here.

    Attachment 1 – Refer to the PowerPoint Presentation Attachment 1_2020 05 OCP Consultation Minor Ailments and Care Gap Analysis

    YOU ARE A : Other
    ON BEHALF OF : An Organization
    Organization name : Shoppers Drug Mart
  • other - POSTED May 21, 2020

    This response was submitted by the Association of Family Health Teams of Ontario. Read the full submission here.

    YOU ARE A : Other
    ON BEHALF OF : An Organization
    Organization name : Association of Family Health Teams of Ontario
  • other - POSTED May 21, 2020

    This response was submitted by the Ontario Medical Association. Read the full submission here.

    YOU ARE A : Other
    ON BEHALF OF : An Organization
    Organization name : Ontario Medical Association
  • pharmacist - POSTED May 21, 2020

    I fully support the implementation of prescribing for minor ailments in Ontario for those that are properly educated. It is important that when minor ailments prescribing goes forward, Pharmacists have access to the resources necessary to make a complete assessment including ConnectingOntario. Pharmacists must receive proper financial compensation similar to that provided to other healthcare providers who would otherwise conduct the same assessment. If there is inadequate or a complete lack of financial compensation for providing the assessment, then writing a prescription to the patient will present a conflict of interest. Pharmacists are currently on the receiving end of much scrutiny from the public being touted as “price-gougers”.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacy assistant - POSTED May 21, 2020

    Expanding the scope of pharmacists will definitely benefit many Ontarians as they are one of the most accessible front-line healthcare professionals. The ability to prescribe medications for minor ailments is a step in the right direction for an improved Canadian healthcare system. I am glad to see this coming to Ontario.

    YOU ARE A : Pharmacy Assistant
    ON BEHALF OF : Myself
  • applicant - POSTED May 21, 2020

    As a current pharmacy student, I believe expanding the scope of practise would allow pharmacists to improve patient health outcomes. Patients would have increased access to effective care.

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
  • other - POSTED May 21, 2020

    I am a 3rd year pharmacy student at the University of Waterloo School of Pharmacy. I am in strong favour of minor ailment prescribing as I believe it will be an excellent addition to the pharmacy profession in Ontario. Through our course curriculum, we are well equipped with skills to assess patients via questioning, rule out red flags that warrant referrals, and recommend appropriate treatments when applicable. Through our placements, we receive lots of clinical experience and experience using additional resources when needed. A good idea to look into would be to use different terminology other than “minor” ailments as some of these conditions may be very bothersome for patients and they would not appreciate having it referred to as “minor”.

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Phone Number (optional) : 9058724370
  • pharmacist - POSTED May 21, 2020

    This list is a great starting point for pharmacist prescribing as it encompasses many common ailments that have require no lab tests and thus can be treated by an RPh, who have more than enough knowledge needed to do so. I do think it would be incredibly beneficial for patients and the healthcare system if Epipens, diabetic supplies (test strips, lancets, ketostix, glucose monitors, Freestyle Libre sensors), and contraceptives were included in this list. In regards to contraceptives in particular, RPh prescribing would allow women greater access to birth control and would also be suitable for women experiencing dysmenorrhea that is not responsive to NSAIDs, and as with other minor ailment prescribing, requires no lab tests. I look forward to seeing pharmacists step up to fill this new role in making healthcare and medications more accessible to all, and I hope that this list continues to expand as patient outcomes improve and the public sees the value of pharmacist prescribing.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • applicant - POSTED May 21, 2020

    I am in favour of this. As a student, I have learned in-depth about many common ailments and feel I will be well-prepared for this. With appropriate resources and compensation, minor ailments prescribing will be a great step forward for the pharmacy profession. I would like to see guidance on how pharmacies can make time for documentation and following-up with patients.

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
    Phone Number (optional) : 6475041791
    Organization name : University of Waterloo School of Pharmacy
  • pharmacist - POSTED May 21, 2020

    I am very concerned about these changes. We especially need to keep prescribing at arms length from dispensing. I don’t feel that it is in anyone’s best interest to allow pharmacists to prescribe. Rather than allow prescribing for these minor ailments, they should be made BTC; non-prescription products available with a pharmacist consult. This would provide the same end result; treating minor ailments but without requiring a prescription. Over the years many products have gone this way (examples include ranitidine, hydrocortisone cream, clotrimazole (topical and vaginal), esomeprazole, fluconazole). A concern that I share with a large number of colleagues is that prescribing quotas/targets will be set for pharmacists to achieve to generate revenue for the pharmacy, especially the corporate ones. This has happened and continues to happen with medschecks, fees for renewals, vaccine administration, and pharmaceutical opinions; any reimbursable service that pharmacists currently provide. This will not lead to the best prescribing practices. Again, a reason to keep the dispensing and prescribing functions separate. Pharmacists will require additional training as mentioned. Providing these services will add more workload, and more stress, to pharmacists who are already under a great deal of both already trying to hit productivity numbers set by corporate office. Regarding prescription renewals; the current system is fine. Expansion of it is not required. This pandemic has shown that there is readily available phone or on-line access to qualified physicians for both prescribing and renewals. This would also keep prescribing and dispensing functions separate. We do not need to administer injections to kids between 2 and 5 years old. I am trained for injections and have been doing so since it was allowed. I am not comfortable with injecting children that young. Obvious answer to this is for me not to do them but corporate pressure will force us to do them. If I refuse to do it, it could cost me my job! I know a number of pharmacists who were, and still are, not comfortable administering injections to anyone but they had to do so to keep their employment. I don’t feel that these changes as set forth are in the best interest of the public, pharmacists, or the profession of pharmacy.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 5193187459
  • pharmacist - POSTED May 21, 2020

    I agree with the above proposed changes. I also believe this list should eventually and will, inevitably, expand to catch up with the other provinces in Canada for a much wider and broader category of conditions prescribed for. Essentially, all healthcare providers must practice with evidence based care. As well, at least for pharmacists, we swore an oath to “do no harm” and benefit patients. During the COVID-19 pandemic, with prescriber offices closed/having reduced hours, and public health officials stressing emerg visits should only be for REAL emergencies, it is evident and quite apparent the essential role of pharmacists as the backbone of the healthcare system. When one assesses, treats, and follows up with a patient, I argue it is crucial, in addition to the knowledge and education of the clinician, to also have rapport with a patient and know them well. As a result, for many pharmacists, and certainly for myself in my practice, I know my patients quite well, and know for a fact I see MOST of them much more frequently than their prescriber. I know their habits, their family issues, follow up with them daily or weekly based on their behaviour, their speech, how they present, etc. This is crucial to understanding patients, and also understanding those that may seek treatment for every imperfection in their body from those that may genuinely benefit from treatment. Regardless, I would like to separate my comment into why I believe pharmacists are highly qualified and capable of performing the proposed regulatory changes to assessing and prescribing for minor ailments, and clarify or debunk some common misconceptions. However, before I begin, as one of my colleagues astutely commented above, it is imperative that the government recognize pharmacists as: a) doctors under the list of those that can name themselves doctors under the RHPA, where dentists/optometrists/naturopaths/chiropractors can already use this term; b) government recognize pharmacists as essential HEALTHCARE providers; c) we are FAIRLY and APPROPRIATELY remunerated for our efforts to ASSESS each patient, NOT by prescription issued to the patient…. Now, why pharmacists are capable of doing this is simple: as pharmacy graduates, and now, as master of or doctor of pharmacy graduates here in Ontario, we are literally drug therapy experts. We spend our entire curriculum on drug therapy TREATMENT. The overlap between physicians and pharmacists is this: physicians are diagnosticians (wrongly they are named prescribers), but need to have a general understanding of pharmacotherapy in order to provide or have a sense of drug treatment options for the diagnosis they have given the patient. Pharmacists are drug therapy experts (wrongly they are named pharmacologists or dispensers), but need to have a general understanding of diagnosis in order to provide or have a sense of how the drug will and can affect and treat the condition diagnosed, and ensure the drug is for the appropriately diagnosed condition for which there is evidence for, AS WELL AS be able to have an understanding of whether further assessment is needed prior to a patient being given a drug. Having said this, once given a reliably self diagnosed condition like one of the above 12 noted ones in the proposed regulation (among many others, around 32 if I recall in other provinces like Saskatchewan that pharmacists can assess and prescribe for), this is a no brainer. FYI, the amount of time that physicians spend on pharmacology is likely equivalent to the amount of time pharmacists spend on diagnosis in their respective faculties in their schooling. Now to clarify some misconceptions. 1. Conflict of interest for pharmacist prescribing: as mentioned above in my comment, we must swear an oath to do no harm and benefit patients. We are also a self regulated healthcare profession with consequences should we breach this patient/public trust. Additionally, if a patient is comfortable with a dentist to order x-rays, diagnose a condition, and treat it by performing surgery/route canal/filling, etc, this is also conflict of interest. Every x-ray, and procedure they perform on you they charge for and make more money yet patients/public trust them that they are only conducting what is necessary for patients and giving them options. For surgeons, every time a surgeon who’s primary form of income is surgery, recommends to a patient to undergo a surgery as opposed to drug treatment or watchful waiting, is also a potential conflict of interest that can jeopardize a patient’s life as it exposes them to anaesthesia, complications pre op, during operation, and post op, and can result in unintended irreversible health consequences. Yet, the public trust them. Even family physicians, they can “dispense” medications, mainly compassionate supplies that are given to physicians by drug companies/drug reps. This is also a conflict of interest, and they can also be given kick backs or other perks that patients/public are unaware of, yet patients are ok with accepting these meds, a lot of times bypassing their pharmacists without having a proper clinical check on other drug interactions or effects with other medical conditions. Many patients and pharmacists can notice “prescribing habits” among various physicians, this can also be a conflict of interest if they only choose to prescribe based on a drug or company or rep they are familiar with, yet the public is ok with this. This is a long-winded yet important concept to get the public and others to understand that pharmacists, although by prescribing have a RISK of conflict of interest, is no greater than the above mentioned. In addition, we do it anyway for over the counter recommendations. Patients are given transparent and evidence based options/recommendations, and the patient ALWAYS has the final say. 2. What if a more serious diagnosis/condition is missed? Again, as noted above, pharmacists are trained HEAVILY in their schooling to know the difference between when they can treat and WHEN TO REFER… Keep in mind that referrals are in stages as well: there’s referrals to emerg STAT, there’s referrals for assessment with physician in 1-2 days, and referrals that are non urgent. In fact we do this many many times already during a regular day, and our physician/dentist/optometrist, etc counterparts rely on us for this, because we are more commonly than not the very first points of contact to the healthcare system for the general public/patients. So actually a core part of our day is assessing a patient to see if we can treat them, provide education, send them home, or refer them to another more qualified provider based on their ailing condition. Those that say we may miss a cancer, etc, this is my response: the likely treatment noted above in the proposed amendments are the ones that likely all other healthcare providers would opt with first, AND IF IT DOES NOT WORK, then we look further (if there are no blaring red flags to begin with). When do you recall a physician ordering an HIV panel for oral thrush for you at a walk-in clinic, your family doc, or in emerg, without noticeable other signs/symptoms eluding to HIV? Or for hemorrhoids thinking anal cancer, etc? Based on guidelines, all ordered blood work and additional testing should be evidence based as it can be invasive to a patient AND ALSO COSTS HEALTHCARE MONEY, that must be utilized appropriately. These conditions can be assessed by a pharmacist and if we believe there is something more than meets the eye, we will happily refer for interest of patient care, in interest of “doing no harm”, and in interest of fearing for our own license. Physicians should stop being afraid of us stepping on their toes – there’s plenty of other things that are well worth your time and schooling and education – there will ALWAYS be more patients than there is help from us healthcare providers, don’t you worry. By the way, primary care providers ALSO must know when to refer to specialists, etc. I am excited for these proposed amendments to come into play, as it is shown through various journals and research that pharmacist interventions, in various conditions, and in CONJUNCTION with other healthcare providers, WILL MOST LIKELY result in better patient care, and therefore reduced healthcare spending, and everyone WINS. This is the goal, and this is my dream. For God’s sake, there’s countless evidence to support pharmacist intervention with hypertension/diabetes/hyperlipidemia, etc, so this is only the beginning of, I hope, better patient care as a byproduct of the government utilizing pharmacists and, therefore, other healthcare providers, to their FULL SCOPE that they learned and practiced and studied in their respective health discipline schooling. Thank you 🙂

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • other - POSTED May 21, 2020

    I am a third year pharmacy student at the University of Waterloo School of Pharmacy. Firstly, I have just finished reading the comments of the Ontario Medical Association. I must say it is disappointing to hear that they reiterate concerns that have been consistently disproven through pharmacy practice research. As a student who has had the opportunity to practice in multiple provinces, I have seen first hand that an expanded scope of practice for pharmacists leads to better healthcare of patients. While I am in agreement with the current proposal, I believe it must only be the beginning. The government must fully understand that the conditions mentioned in this proposal are not only a fraction of the capabilities of pharmacists, but it is also a fraction of how pharmacists practice in many other Canadian provinces. Secondly, I would like to suggest that the OCP ensure right off the bat that pharmacists are able to conduct these assessments through virtual services (as is currently done by physicians and nurse practitioners). This will be relevant both now during the pandemic and afterwards as patients become accustomed to receiving healthcare services through virtual means. Thirdly, I am in agreement with the fact that, moving forward, we must partner with the OMA and other stakeholders to create a functional electronic health record in the province of Ontario. This is key to ensuring the full success of both this expansion of scope and all future expansions. Thank you to the Ontario Pharmacists Association for advocating on behalf of all pharmacy professionals in Ontario. Thank you as well to the Ontario College of Pharmacists for drafting up this proposal. Both of these organizations play a key role in shaping our future and it is nice to see them work well together.

    YOU ARE A : Other
    ON BEHALF OF : Myself
  • pharmacy assistant - POSTED May 22, 2020

    This incredible progress to fully recognize and utilize pharmacist’s knowledge and potential. It could help save time for physicians, decreasing wait times, and optimizing the health care system. I am really glad this will coming to Ontario. – Current Pharmacy Student

    YOU ARE A : Pharmacy Assistant
    ON BEHALF OF : Myself
    Phone Number (optional) : 6473023974
  • pharmacist - POSTED May 22, 2020

    I am supportive of pharmacists being able to prescribe for minor ailments. There are a number of antimicrobials on this list, though. With antibiotic stewardship in mind, I believe that pharmacists are often better positioned to know the most effective treatments, but prescribers working in family health teams or larger organizations have access to local guidelines that are supported by large teams for information. It would be helpful if OCP supported work and made available or endorsed a guideline or reference to existing guidelines to ensure pharmacists in the community setting are not left to their own training, which can become outdated, to keep up with the latest prescribing information. For example, collaborations with Public Health Ontario Stewardship efforts. Additionally, I note that there are no age limits to the minor ailments prescribing. This is somewhat concerning as pediatrics training in the pharmacy schools is lacking. Recognition of when to refer younger patients for UTIs, which are rarely “uncomplicated” could lead to overprescribing antimicrobials. I believe there should be some disease-specific restrictions on age when it comes to prescribing for most conditions.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 4166067486
  • applicant - POSTED May 22, 2020

    I am absolutely in favour of the expanded scope of practice draft that will allow pharmacists to prescribe for minor ailments. There is a ton of potential here for pharmacists to help patients get timely access to healthcare for a condition that is not considered “minor” to them. This decision is best for the patient population, and may also save money for the Ontario Government by reducing emergency room visits and unnecessary appointments with a physician . As a student that advocates for the profession, this opportunity is very exciting to advance the profession. Pharmacists are the medication and pharmacology experts. In terms of liability, if any pharmacist is ever unsure, they can refer patient to their physician. Having said that, in my opinion it is in the profession’s best interest that pharmacists receive reimbursement for the assessment, instead of having to generate a prescription. In order for this to be a possibility, pharmacists must be able to allocate an appropriate amount of time to assess a patient. If a pharmacist is unable to provide that time to the patient because of a hectic work environment then they should not be forced to assess. There should be guidelines in place that states if a pharmacy has too much volume and inadequate staffing, then they will not be required to assess, which could hopefully combat the idea of quotas.

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
    Organization name : University of Waterloo - Student Pharmacist
  • other - POSTED May 22, 2020

    This response was submitted by the Canadian Society of Hospital Pharmacists. Read the full submission here.

    YOU ARE A : Other
    ON BEHALF OF : An Organization
    Organization name : Canadian Society of Hospital Pharmacists
  • applicant - POSTED May 22, 2020

    I believe that implementing these minor ailments will be a great step towards maximizing patient’s ease of access to pharmacists and will result in more efficient care.

    YOU ARE A : Applicant
    ON BEHALF OF : Myself
  • other - POSTED May 22, 2020

    Hello, I am a strong proponent of wanting minor ailment prescribing authorities for pharmacists to help hopefully reduce the burden from ER/acute clinics to more readily available pharmacies. The college protects the public and I would like the college to consider the safety of public with the resources currently in place to achieve the clinical services we are speaking of here. More specifically: – lack of time to rule out red flags during the patient interaction, – lack of laboratory data/patient history, – lack of privacy in many pharmacies to be able to thoroughly discuss the issue at hand are all compulsory, in my opinion to truly take the load off of ER/Acute clinics and help the public effectively. Again, I am in favor of this progression and am emphasizing the need for other services which go hand in hand with minor ailment prescribing. Having the availability of such resources will further help the college (and other governing bodies) to quantitatively measure the reduction in ER/Acute care resources and public’s health –> therefore the contributions of the pharmacists to the province’s health care state. PharmD Student (Rx 2020)

    YOU ARE A : Other
    ON BEHALF OF : Myself
    Phone Number (optional) : 2269895494
    Organization name : University of Waterloo
  • other - POSTED May 22, 2020

    This response was submitted by Northwest Telepharmacy Solutions. Read the full submission here.

    YOU ARE A : Other
    ON BEHALF OF : An Organization
    Organization name : Northwest Telepharmacy Solutions
  • other - POSTED May 22, 2020

    This response was submitted by The Neighbourhood Pharmacy Association of Canada. Read the full submission here.

    YOU ARE A : Other
    ON BEHALF OF : An Organization
    Organization name : The Neighbourhood Pharmacy Association of Canada
  • other - POSTED May 22, 2020

    This response was submitted by The Ontario Pharmacists Association. Read the full submission here.

    YOU ARE A : Other
    ON BEHALF OF : An Organization
    Organization name : The Ontario Pharmacists Association
  • pharmacist - POSTED May 22, 2020

    Dear OCP, Thank you for giving us the opportunity to comment on this draft proposal. I am greatly supporting this movement as I strongly believe we as Pharmacists are qualified and WE can take this move onward to help ease the strain on our health care system (as well as costs). We have to remember that just because we’d be given an opportunity to prescribe, doesn’t mean we’d be prescribing left and right. As pharmacists, we are already providing OTC recommendations (which is effectively a form of prescribing). Most OTC products are still “drugs” with potential for adverse effects and interactions with prescription medications. Our expertise in medication knowledge and our thought process on pharmacotherapy management is well suited for “minor ailments.” To address the concerns that others have brought up, (particularly the risk that perhaps we as pharmacists may miss differential diagnoses), we have not only been trained to recognize these common ailments, but when to refer to the appropriate healthcare provider. It’s true that perhaps when assessing bacterial conjunctivitis, maybe we are missing something else? However, with our self-care tailored follow up times, this includes conditions/time-frame of when it’s appropriate to seek your provider (i.e. if symptoms don’t improve in 24 hours). If that method would aid reduced visits to the ER or other clinics, this would allow those that NEED it more urgently to access those services more readily. Remember, Canada has some of the worst waiting times in our healthcare system, so there is clearly something wrong with our current system. Look at the other provinces that have already implemented common ailment prescribing. Again, just because we’d be given this scope does not mean we’d be prescribing left and right. Secondly, to ensure the above points I mentioned are done safely, pharmacists wishing to prescribing should have certificate of proof (similar to how Alberta has additional training for prescribing). This will ensure that those who are confident in this scope will do so safely to our patients. Thirdly, I understand those that are concerned about the increased workload and lack of compensation we get for some of our services. Unfortunately, I see this as a concern too. If this service is to be done for free, think about how this may compromise the care of some patients. I understand compensation shouldn’t be a priority for a profession that focuses on helping people. As pharmacists, we want to do the most for our patients, but a lack of incentive could deter us from providing the best care. Are there other HCPs out there that are expected to provide medical services with no compensation? For those concerned that this service would increase more workload under corporate demands etc. We have to remember that this scope shouldn’t mean prescribing left and right. We’re just given additional options to provide care for certains cases when we deem it appropriate. The college should ensure corporations UNDERSTAND THIS so as not to compromise patient safety (fatigue due to extra workload and unnecessary prescribing for billing purposes). The hope is that this would not lead to the similar situation of “MedsChecks daily quota.” Additionally, if this service is to be provided from certified individuals (as mentioned above), this ensures Pharmacies that feel they can provide this service properly (considering their typical workflow) will have the pharmacists certified for this service. If a Pharmacy workflow/daily script count is too busy, those pharmacies may have to reconsider. Technology is becoming more incorporated into Pharmacy (i.e. aid in dispensing to allow Pharmacists and staff more attention to patients) and I hope the profession adapts to this change (a topic for another time). I understand the concerns coming from this. Every individual’s opinion should be respected; however, our profession needs to adapt to our dynamic healthcare system if we want to continue to provide the best care to our patients. Staying put and doing nothing is not in the best interest for our patients.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
    Phone Number (optional) : 6478786595
    Organization name : University of Waterloo School of Pharmacy
  • other - POSTED May 22, 2020

    We are pleased to provide comment to the OCP open consultation regarding Expanding Scope of Practice: Pharmacist Prescribing for Minor Ailments. It is with great pleasure that we welcome the opportunity for expanded scope to prescribe for minor ailments within our pharmacy practices in Ontario; finally joining our pharmacy colleagues from across most of Canada in delivering improved access to quality primary healthcare to our communities in this regard. This being said, we have identified a few areas upon which we believe the Regulations could be improved. These are: With respect to section 35, (2) (4) (g) i. (has successfully completed such educational requirements as have been specified by Council); we question the intent of this being included, as we believe that section 35. (2) (4) (a) as written (possesses sufficient knowledge, skill and judgment respecting the drug and the patient’s condition to prescribe the drug for the patient) already addresses protection of the public for competent care. Practitioners will pursue educational programming as appropriate and necessary to their individual circumstance to ensure competence to practice any activity within any specified scope. There are numerous accredited programs on minor ailments assessment and prescribing available to practitioners, and the regulations should not need to be prescriptive in this manner. With respect to the Schedule 4 and the LIST OF MINOR AILMENTS AND CORRESPONDING DRUG CATEGORIES (Arranged by American Hospital Formulary Service (AHFS) Pharmacologic-Therapeutic Classification), we find it curious that the list of drugs from which a pharmacist may prescribe for a given minor ailment is limited to the noted AHFS classes, rather than to any drug from schedule I, II, III or unscheduled (but excluding drugs listed in the Controlled Drugs and Substances Act) that has an approved indication for the product from Health Canada, and/or is supported by evidence (i.e. accepted as best practice or accepted clinical practice in peer-reviewed clinical literature, or is part of an approved research protocol. By limiting to the AHFS categories, the pharmacist may be constrained in their ability to prescribe the most appropriate treatment for the patient and thus unduly burden the patient to seek an alternative provider, as the pharmacist cannot proceed in a manner consistent with section 35 (2) (4) (g) ii (has determined that prescribing the drug is the most appropriate treatment for the patient’s condition). We would recommend that consideration be given to allowing the choice of drug that can be prescribed to include any drug from schedule I, II, III or unscheduled (but excluding drugs listed in the Controlled Drugs and Substances Act) that has an approved indication for the product from Health Canada, and/or is supported by evidence (i.e. accepted as best practice or accepted clinical practice in peer-reviewed clinical literature, or is part of an approved research protocol, similar to the approach used by pharmacy regulators in other leading provinces. And lastly, while we are heartened to have an initial list of 12 minor ailments for which pharmacists will now be able to prescribe in Ontario, we trust that this is just the initial step towards an expanded list and scope like found in other Canadian provinces that addresses the many conditions for which pharmacists are ideally positioned and skilled to attend to in serving the healthcare needs of the public, including notable conditions like herpes zoster (shingles) and contraception management.

    YOU ARE A : Other
    ON BEHALF OF : An Organization
    Phone Number (optional) : 902-440-0388
    Organization name : Sobeys Pharmacy
  • pharmacist - POSTED May 22, 2020

    I support this expanded scope for registered pharmacists. They already have the education and practical experience in recommending treatments and referring patients to other healthcare providers when required for these minor conditions. They are also educated, trained and regularly dispense the prescription-requiring treatments so they will be aware of the medications indications and potential effects. I have three points on these regulations: 1. The list is much smaller than the original proposed list of minor ailments, I hope there will be an established mechanism by which more conditions can be added relatively simply (i.e. not through legislation) in the future. 2. In the GERD treatments that are allowed to be prescribed, PPIs are left out. This seems odd, considering that some PPIs are OTC and can be purchased without intervention by a pharmacist. I would recommend including that classification as well. 3. I suggest that OCP set out clear expectations around documentation and educational requirements.

    YOU ARE A : Pharmacist
    ON BEHALF OF : Myself
  • pharmacy assistant - POSTED May 22, 2020

    This is a great move forward for pharmacists and other health care providers of Ontario – Pharmacy Student

    YOU ARE A : Pharmacy Assistant
    ON BEHALF OF : An Organization
    Organization name : University of Waterloo School of Pharmacy
  • Other - POSTED May 22, 2020

    May 22, 2020 College of Pharmacists 483 Huron St, Toronto, ON M5R 2R4 Re: Expanding Scope of Practice: Pharmacist Prescribing for Minor Ailments Across Ontario, people often contact and speak to pharmacists, seeking their professional opinion on solutions to common ailments, pharmacological questions, seeking education on inhalation therapy, or to if receiving the flu shot. Pharmacists play an important role on health care teams that serve patients, optimize health outcomes, and support a sustainable health system. Increasing pharmacists’ scope of practice will improve access to care for patients by eliminating current barriers. While NPAO is in favour of supporting increased scope of practice for pharmacists, consideration needs to be given to: • Managing conflict of interest with pharmacists that own a pharmacy, or where pharmacist will financially benefit for prescribing and filing that prescription; • Ensuring that the College of Pharmacists have appropriate quality assurance processes in place to ensure pharmacist who choose to prescribe have obtained the knowledge skill and judgement to appropriate assess, develop a differential diagnosis prior to prescribing; • Ensuring the pharmacist has appropriate professional liability protection to manage the increased litigation risk; • Ensuring the patient has appropriate follow-up regardless if a prescription is provided or not, including the pharmacist contact information; • Clarification of what is referred to as an ‘analgesic’ in the management of MSK or dysmenorrhea. Does this include prescribing controlled substances; and, • Anti-infective Guidelines for Community Acquired Infections (2019) state that ‘the presence of leukocytes and nitrites should be assessed prior to making the decision of whether an antibiotic is required’ (p. 64-65). Will pharmacists have access to onsite urinalysis sampling?

  • member of the public - POSTED May 22, 2020

    I am completely in agreement with pharmacists prescribing medication further. Pharmacists know these medications like the back of their hands, and would be able to quickly and efficiently deal with patients, as well taking the load of patients that have simple questions about medications or a perception that could be dealt with easily by a pharmacists off of doctors and maybe even reduce the wait times of appointments. Pharmacists are a vital component of the medical world, and should have the responsibility of prescribing the medications they’ve studied for years.

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself
  • member of the public - POSTED May 22, 2020

    I think pharmacists are very knowledgeable and often see and know patients better than patients’ doctors. They also know medications and interactions better than doctors and insurance costs and can recommend meds that are equally effective but lower cost on behalf of the patient. I believe pharmacists are underrated and allowing them more responsibilities will earn them more respect and credit. Also they should be titled as Dr as they go through a gruelling 4 year study period like doctors and are in fact Drs of medicine. This would also greatly help in acknowledging pharmacists as highly knowledgeable and earn them the respect they deserve from general public and doctors Thank-you!!

    YOU ARE A : Member of the Public
    ON BEHALF OF : Myself