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pharmacist prescribingLed by Lisa McCarthy, this project is exploring both existing and potential avenues for independent pharmacist prescribing in Ontario.

In the project’s renewal and adaptations component, the team is assessing the uptake and impact of pharmacists’ authority to renew and adapt prescriptions on patients and our health system.

Along with initiating smoking-cessation therapy, the authority to renew chronic medications and adapt the dose, formulation or route of prescriptions were introduced as part of the expanded scope of pharmacist practice in late 2012. Understanding provision of this service is providing important insight into this recently expanded scope of practice.

Members: Nancy Waite (co-lead on the future opportunities for pharmacist prescribing component), Lisa Dolovich, Kelly Grindrod, Nedzad Pojskic
Research coordinator: Elizabeth Bojarski
MSc student: Ida-Maisie Famiyeh

PharmD student on APPE rotation: Abhijeet Minhas

Pharmacist renewal and adaptation of prescriptions

This component of the project has two broad research goals —

  1. To determine the uptake by and impact on pharmacists and pharmacies of the authority granted to pharmacists to renew chronic medications and to adapt the dose, formulation, regimen or route of prescription
  2. To identify what determines service provision and options to overcome identified barriers
Methods

This project uses a mixed-methods approach that involves a provincial survey, audit of prescription records and patient interviews.

Provincial survey: An online survey of pharmacists practising in community settings is exploring whether pharmacists are renewing and adapting prescriptions, the frequency with which this is being done, and identifying the facilitators and barriers to uptake of this service by pharmacists and pharmacies. The survey has been shaped for the Ontario context based on the work of Dr. Lisa Guirguis and her colleagues in Alberta.

Prescription record audit: Pharmacies are being recruited to participate in a descriptive analysis of the prescriptions they have renewed or adapted, the impact of renewal and adaptation, and the characteristics of the patients receiving the service.

Patient interviews

Patients’ awareness of this expanded scope authority and its impact on their care are being explored.

Implications

This study is completing the preliminary steps necessary to establish estimates of early uptake of a new service pharmacists can provide with the intention to inform future health system planning.

Future opportunities for pharmacist prescribing

This work is understanding stakeholder perspectives about possible opportunities for expanding pharmacist prescribing in Ontario. In Alberta, pharmacists can obtain special authorization to prescribe within their skill set. In some other Canadian provinces, pharmacists are prescribing for commonly encountered minor ailments.

Learn more about this project

Journal publications
  1. pharmacist prescribing publicationsFamiyeh IM, McCarthy L. Pharmacist prescribing: A scoping review about the views and experiences of patients and the public. Res Social Adm Pharm. 2016 Jan 18. doi:10.1016/j.sapharm.2016.01.002 [Epub ahead of print].
  2. Lee R, McCarthy L. Canadian “minor ailments” programs: Unanswered questions. Can Pharm J, 2015; 148(6):302–4.
Recent presentations

43rd North American Primary Care Research Group Annual Meeting • Cancun, Mexico • Oct 24–28, 2015

  • The Ontario pharmacist prescribing survey: Understanding the uptake of prescriptive authority among community pharmacists (poster, abstract)
    McCarthy L, Bojarski E, Guirguis L, Pojskic N, Grindrod K, Dolovich L, Waite N

Ontario College of Pharmacists • Toronto, ON • Oct 20, 2015

  • Lisa McCarthy, Linda MacKeigan and their co-supervised graduate student Ida-Maisie Famiyeh made a presentation titled “Scoping review about patient and the public’s views about pharmacist prescribing” to the Ontario College of Pharmacists.

2015 Trillium Primary Health Care Research Day • Toronto, ON • Jun 4, 2015

  • Jurisdictional and evidence review of pharmacist-led minor ailments programs (poster)
    Lee R, McCarthy L