New powers for pharmacists on the cards

From the Australian Broadcasting Corporation:
Pharmacists may one day gain limited prescription powers to ease pressure on GPs.

Advocates say pharmacists are well qualified for the extra role.

Tasmania's Health Minister, Lara Giddings, says GP numbers are expected to fall as demand grows.

She says pharmacy prescription is one of several solutions that should be considered. ...more

A prescription to improve health care

This is a decent article regarding pharmacist prescribing, but I thought I'd point out that the example cited in the early part of the article is a very poor one. Pharmacists would not be diagnosing bladder infections at the local pharmacy counter as Ms. Bessette would prefer. Diagnosing is a physician's area while optimally managing drug therapy once diagnosed is where a pharmacist can shine.

From the North Bay (Ont.) Nugget:
Tina Bessette has been at the mercy of a doctor shortage.

And she doesn’t like it.

The idea of giving pharmacists, nurse practitioners, midwives and optometrists more prescribing power couldn’t come at a better time, Bessette said Tuesday.

“It’s really frustrating, especially for those who are waiting hours at a walk-in clinic just to get their medications refilled,” she said.

“It would be really helpful for the patient if more medical professionals could prescribe drugs. It’s exactly what we need and it will certainly help because right now the situation is horrible.”

Most recently, Bessette has had to wait seven days before she could get the necessary medication she needed for a bladder infection.

“The nurse practitioner who treated me didn’t have the authority to prescribe medication so I had to make a doctor’s appointment and the earliest I could get one was about seven days later,” she said.

“We need these types of people to be able to prescribe medication. Doctors are so busy, many times you can’t get hold of them to make an appointment or it’s not soon enough.” ...more

Ontario pharmacists could soon prescribe drugs

From the Globe and Mail:
Ontario patients could soon get drug prescriptions from their local pharmacist as the governing Liberals look to join other provinces and expand the prescribing powers of pharmacists, nurses and other non-physicians.

Despite concern from the country's doctors, Health Minister George Smitherman is asking for advice on who should be allowed to prescribe drugs and whether nurse practitioners — who have some prescribing power — should be able to write prescriptions for a wider array of medication.

“You are seeing more and more the capability of the pharmacists being unlocked to serve patients,” Mr. Smitherman said.

“I think it's an appropriate thing to take a look at. Obviously it's got to be done with . . . an abundance of caution on behalf of patients but also recognizing that, for patients, it can be a matter of extraordinary convenience.”

The Ministry of Health is quietly commissioning a study which would examine whether those who have prescription authority now — like midwives, optometrists and nurse practitioners — should be able to prescribe more classes of drugs. ...more

Increasing pharmacists' powers raises concerns

From the Globe and Mail:
Getting a prescription refilled or changed in Canada is set to become much easier, but the move to expand the powers of pharmacists is sparking controversy in the country's medical community.

New Brunswick will become one of the first provinces to move forward with legislation to significantly boost the ability of pharmacists to play a greater role in patient prescriptions.

Under proposed changes announced this week, pharmacists would not only provide refills without having to check with the doctor, but could also alter a patient's prescription or assign new medications for minor conditions.

Similar rules are already in place in Alberta and other provinces are in various stages of enhancing the role of pharmacists.

These moves will provide greater convenience to Canadians, who may not have immediate access to a doctor for a new prescription, allow pharmacists to better monitor a patient's response to treatment, and reduce the burden on overworked doctor's offices, said Janet Cooper, senior director of professional affairs at the Canadian Pharmacists Association. ...more

Pharmacists to ease strain on health care

From the Fredericton (NB) Daily Gleaner:
It's going to get a lot easier to get your prescription refilled this fall.

A private members bill amending the Pharmacy Act was introduced in the legislature Tuesday.

Starting Oct. 20, pharmacists will be able to refill prescriptions for chronic conditions.

New Brunswick Pharmaceutical Society registrar Bill Veniot said the change will improve access to health care for New Brunswickers.

"We use the example of a patient who has been on blood pressure medication for 10 years (and) he has run out of his medication before he is able to see his doctor," said Veniot. ...more

Pharmacists soon to prescribe drugs

I find it interesting that the New Brunswick Medical Society is in favour of pharmacist prescribing, while in Alberta the Alberta Medical Association is mostly against the concept. However, it doesn't sound that the N.B. plan is quite as far-reaching as the initial prescribing program that has started in Alberta.

From the Moncton (NB) Times & Transcript:
New Brunswick pharmacists are prescribing their own medicine to help solve the province's overburdened health-care system.

The New Brunswick Pharmaceutical Society has drafted a private members' bill, which will give pharmacists the power to renew, extend, or alter prescriptions and diagnose "minor" and "chronic" conditions and ailments.

The Liberal government tabled the bill and supported it yesterday in the legislature.

Bill Veniot, registrar of the New Brunswick Pharmaceutical Society, called the legislation a step forward for health care in the province, but said pharmacists would not be taking on the work of doctors.

"This is about greater access to pharmacists, greater access to necessary services. It is about the pharmacist being able to work for their full scope of practice."

Health Minister Mike Murphy has echoed the message of pharmacists, who believe they can help cut down on lineups at hospitals and make medications more accessible to New Brunswickers.

"People going to the hospital to get renewals on prescriptions, that won't be happening anymore. We won't be clogging up the waiting areas for that," says Dennis Abud, president of the New Brunswick Pharmacists' Association. ...more

New Brunswick pharmacists to prescribe drugs under new legislation

From the Canadian Press:
Pharmacists in New Brunswick will soon be able to prescribe certain drugs as a result of a bill tabled in the legislature Tuesday.

The bill, which was introduced on behalf of the New Brunswick Pharmaceutical Society, was promised earlier this year in the provincial health plan. "This enhanced role for pharmacists is in keeping with our commitment to give patients better access to health care by enhancing the role of health-care providers," said Health Minister Mike Murphy.

Murphy said people who have an established diagnosis from their doctor for conditions such as allergies, asthma, diabetes or high cholesterol can consider seeing their pharmacist for a prescription.

An example could be someone who has been on blood pressure medication for 10 years but has run out of medication and was unable to see their doctor for a couple of weeks. A pharmacist would be able to provide that patient with medication to allow time for a followup with their doctor. ...more

Alberta unveils health 'action plan'

From the Calgary Herald:
Health Minister Ron Liepert unveiled an "action plan" for reforming the provincial medical system Wednesday morning, but he suggested the sizeable shortage of doctors in Alberta is far from being the only problem facing health care.

Liepert outlined proposals government will consider during a nine-month overhaul of the $13-billion health system, ranging from a new governance model for the province's health regions to monitoring infection control standards.

The plan also moves to address shortages of nurses and doctors, a problem that is so acute in Calgary that an estimated 200,000 people don't have a regular family physician. But Liepert also expressed doubt about the "so-called shortage of doctors."

"Let's not just jump to the conclusion that we have to run out there and hire 1,500 doctors. There are other ways of addressing this problem," Liepert said at the legislature, referring to plans to add physician assistants and give pharmacists more power to manage chronic diseases. ...more

The pharmacist will see you now

From the Los Angeles Times:
Twice a week, Stephen Inns sees patients with high blood pressure at his office in a medical practice in southern England. Usually he conducts a few quick tests, asks them how they're doing and adjusts their medicines if necessary.

Inns isn't a doctor; he's a pharmacist.

He is one of fewer than 100 pharmacists across Britain recently given permission to prescribe drugs for patients and provide basic care, without relying on a doctor. The move is part of Britain's attempt to expand its healthcare system by allowing medical professionals such as nurses and pharmacists to treat patients.

Though many countries are slowly loosening the rules on non-doctors giving out medicines, none has given pharmacists as much power as Britain has in its effort to increase services and cut costs in a financially overburdened health system.

In 2006, Britain expanded the powers of pharmacists to treat patients once they took a training course. Though the number of prescribing healthcare professionals other than doctors remains small, their ranks are growing -- and the government hopes they will someday become the norm. ...more

Prescribing powers gained by 15 pharmacists

From the Calgary Herald:
A group of 15 pharmacists in Alberta has become the first in Canada given powers to prescribe new medications to patients without needing final authorization from a doctor.

They were part of a pilot project to ensure all future pharmacists wanting additional prescribing powers under Alberta's Pharmacists Act are rigorously evaluated before taking on the new responsibility.

"Pharmacists are quite highly educated, and to just be stuck doing dispensing-type things, it's not really a good use of our training and expertise," said Christine Hughes, a pharmacist since 1994. ...more

Doctors critical of optometrists' new role

There is a couple of paragraphs later in this article that mentions pharmacist prescribing in Alberta.

From the Calgary Herald:
Alberta's eye specialists and optometrists are at odds over an agreement allowing optometrists to treat more patients with eye diseases -- a dispute that may mark the next battle around the changing role of medical professionals in the province.

Physicians with the Ophthalmological Society of Alberta said Tuesday they are concerned optometrists don't have enough training to treat patients with serious eye diseases such as glaucoma, noting they are not medical doctors.

Optometrists receive four years of training in optometry following their bachelor's degree. Ophthalmologists are physicians who receive five years of hospital training for their specialty after medical school. ...more

B.C. vows huge changes to health care

From the Victoria (BC) Times Colonist:
...Nurses aren't the only health-care professionals who will see their duties expand. The Liberal government will also enable pharmacists to authorize routine prescription renewals, "making it easier for patients with chronic illnesses to manage their conditions" and reducing visits to the doctor......more

Value of first pharmacist prescriber pilots questioned

The concept of pharmacist prescribing is gaining momentum around the world. But it looks like no matter where you go, physicians are resisting the move in this direction.

From Health Care Republic:
Independent prescriber pharmacists are being put in place in GP surgeries, despite GPC protests that the move threatens the future of general practice.

GP practices in Hampshire are among the first in the country to be using independent prescriber pharmacists.

Stephen Inns, a pharmacist and lecturer at the University of Portsmouth, has been running two four-hour hypertension clinics a week since obtaining his independent prescriber certificate last November.

The clinic treats around 1,800 patients at the Bishops Waltham surgery in south Hampshire, which has a list size of 13,500. ...more

Women may get pill without prescription

From Reuters (UK):
Women could be able to get the contraceptive pill from their chemist without a prescription, a health minister said on Thursday.

Lord Darzi, a leading surgeon brought into Prime Minister Gordon Brown's government, said the programme could be piloted among pharmacists or nurses.

The pill is currently available only with a prescription from a doctor, although most pharmacies are able to provide the "morning-after pill" without a doctor's authorisation.

Darzi suggested women could be given the oral contraceptive after a full assessment by a trained health professional. ...more

Liberals play up health reforms

From the Fredericton (NB) Daily Gleaner:
The Liberal government will soon unveil its provincial health plan, which includes help for seniors to stay in their homes, allowing pharmacists to prescribe some medication and regulating midwifery.

There will also be a dial-a-dietician service and more restrictions on the display of tobacco products.

"A self-sufficient New Brunswick requires healthy people with access to high-quality and accessible health-care services," said Lt.-Gov Hermenegilde Chiasson, who read the throne speech Tuesday. ...more

Alta. pharmacists want prescribing privileges

I'm glad that I'm in the group of 30 to 40 Alberta pharmacists that are applying for advanced prescribing. I mailed in my application yesterday. It's still not clear when the applications will be approved, but it won't be until more steps in the process are completed in late September. Watch this blog for more updates.

From the Saskatoon Star Phoenix:
A handful of Alberta pharmacists will make Canadian history -- and likely stir a fresh round of debate about their new role -- when they apply for controversial prescribing privileges early next month.

Between 30 and 40 pharmacists in the province will undergo an assessment in the coming weeks to ensure they are qualified to write new prescriptions, adjust dosages and change drug therapies.

"This group of pharmacists will have a larger tool box, a broader spectrum of drugs for the conditions they are already treating," says Greg Eberhart, registrar of the Alberta College of Pharmacists. ...more

A prescription for change

From the Portage (Man.) Daily Graphic:
Pharmacists in Manitoba may be able to prescribe drugs in certain cases if the province has its way.

Pharmacists, doctors and patients are being consulted as new regulations are being drafted in accordance with Manitoba’s Pharmaceutical Act passed last fall. The Act gives pharmacists the authorization to write prescriptions in cases such as when a patient with a chronic condition needs a refill or when a patient has developed a reaction to a prescribed drug and requires a substitute.

“Pharmacists are not interested in taking over the job of doctors and, in Manitoba, doctors are not interested in inhibiting a pharmacist’s ability to help his or her client,” said Health Minister Theresa Oswald yesterday.

“We’re not trying to discourage people from getting the care they need. It just means in some circumstances where patients would go to the doctor for a routine signature that would not have to happen.”

The province has tried to assure opponents of the legislation it will make sure all the appropriate checks and balances are in place so neither pharmacists nor patients abuse the system with regard to visits and prescriptions. ...more

Only doctors may prescribe, CMA resolves

From the Globe and Mail:
Canada's doctors are bitterly denouncing the idea that pharmacists be allowed to prescribe drugs independently, saying such a practice places patients at risk.

Independent prescribing by pharmacists, nurse-practitioners and midwives is already permitted, to varying degrees, in six provinces.

Members of the Canadian Medical Association, gathered for their general council meeting in Vancouver, passed a series of motions yesterday, saying only physicians should prescribe, either directly or by delegating their powers to another health professional.

Groups representing pharmacists and nurses condemned the position, calling doctors paternalistic, paranoid and pathetically desperate to protect their turf.

"Despite their obvious skills, pharmacists don't have the totality of skills to make sound clinical judgments," said Gordon Pugsley, president of Doctors Nova Scotia. "It's an enormous leap of faith to think that care can be delivered at the same high level by someone other than a physician." ...more

Doctors at national meeting oppose pharmacists prescribing medication

Here's a similar article as below, but this one has some additional information.

From CBC News:
The majority of doctors attending a convention of the Canadian Medical Association have voted against allowing pharmacists to prescribe medication when they're part of a team caring for patients.

Fifty-six per cent of the 268 delegates at Tuesday's meeting opposed a motion by their national lobby group to let pharmacists have an expanded role within collaborative care teams.

Doctors said they should lead such teams and prescribe medication because they're adequately trained to take a patient's medical history, do a physical exam, order and interpret tests and come up with a diagnosis.

The Canadian Pharmacists Association says an expanded role for pharmacists is an international trend that includes an effective use of health professionals. ...more

MDs reluctant to expand role of pharmacists

I'm disapointed but not surprised regarding the results of this vote. It will be even more interesting once the first Alberta pharmacists are given the ability to prescribe beyond the current modification and adaptation of physician's prescriptions.

From the Globe and Mail:
A majority of doctors attending a convention of the Canadian Medical Association in Vancouver don't support an expanded role by pharmacists to manage and monitor medication when patients are cared for by a team of health professionals.

Fifty-six per cent of 268 doctors voted against giving pharmacists a larger role within such teams.

Many of the delegates at the meeting say doctors should lead a collaborative care team and they should be the ones prescribing medication.

The Canadian Pharmacists Association says an expanded role for pharmacists is an international trend that includes primary health-care reform. ...more