Pharmacists in N.S. say they want to do more to support the strained primary health-care system

Primary care clinics in Nova Scotia Stephanie Tsicos speaks with the Pharmacy Association of Nova Scotia to find out how the primary care clinics are going in the province.

The association representing Nova Scotia pharmacists say pharmacies should be better utilized in order to improve access to timely primary health care.

Allison Bodnar, CEO of the Pharmacy Association of Nova Scotia, said pharmacies have the potential to ease more pressure on family doctors and nurse practitioners by taking on vaccine programs, medication renewals and acting as initial prescribers for some ailments.

“We have a very broad scope (of care) already, is it everything we can do? Probably not, but there’s so much within that scope we need to utilize,” Bodnar said in an interview Wednesday.

“Renewals, immunizations, medication management, being initial prescribers, and sharing in that care — that’s what we need to lean into to really make changes in the system and to open up capacity.”

Many of these health services are available at 24 pharmacy primary care clinics that are operating as part of a pilot program scheduled to run until April 2024. The clinics provide assessment and prescribing for strep throat, pink eye, UTIs, chronic disease management dor diabetes, asthma, COPD, and prescription renewals for all medications.

The project launched at nine pharmacies in February is aimed at changing “how we deliver healthcare to help Nova Scotians get the care they need faster,” Health Minister Michelle Thompson said in a statement at the time.

Nova Scotia’s primary health-care system is under strain, with a shortage of family physicians and more than 148,000 people registered on the provincial wait list for a primary care provider as of June 1.

Bodnar, accompanied by Nova Scotia College of Pharmacists CEO and registrar Beverley Zwicker, told a legislative committee Tuesday that these pilot clinics are well liked by patients and pharmacy staff. In the first six months of operation, more than 41,000 medical services were provided, “including 10,000 strep assessments — all people that would have had to see care elsewhere,” she said.

The pharmacy association CEO said government should move towards establishing systems so that pharmacies can co-manage chronic disease patients alongside doctors or nurse practitioners, and for pharmacies to fully manage the provincial immunizations and injections.

“A technician can do flu shots, a pharmacy can do flu shots. We don’t need to waste (physician) appointment times on giving flu shots,” Bodnar told the standing committee on health.

The same goes for most medication renewals, she said.

“Most prescription renewals, and I mean millions a year, should be done by pharmacists, at a pharmacy by a professional familiar with the patient.”

“We should not be wasting valuable ER, urgent care, mobile care, virtual care or (nurse practitioner) and physicians’ time on most of these prescriptions,” Bodnar said.

During an availability Wednesday, Premier Tim Houston said he’s in favour of expanding pharmacists’ scope of practice and hopes to see more primary care pharmacy clinics established.

“We started with a pilot of 12 and now it’s up to 25. I think there are over 300 pharmacies in the province, so absolutely we’re looking to expand,” Houston said.

“The fix to health care isn’t one solution, it’s a number of solutions, and certainly the pharmacy clinics have been a major part of that,” he added.

Bodnar said in order to harness the full potential of Nova Scotia’s pharmacies, government must quickly move on setting up its digital medical record system, establish MSI codes to bill services, and support the infrastructure needed to support collaborative care with pharmacists.

“There’s all of those discussions and negotiations to be had in order to plan this out. We know our teams are super keen to do this, we know the benefit of it,” she said.

“There’s just a lot of administrative and procedural work that has to happen between here and there. This is why it’s so important to start now so there’s no gap when the pilot is over.”

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