'A good way of doing triage'
November 23, 2008
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Joseph Hall
HEALTH REPORTER
A mortar bowl of controversy is now being ground in Ontario over the possibility pharmacists may soon be allowed to prescribe some of their own medicines for a number of minor ailments.
But in the United Kingdom, where the practice has been long established, it's just what the doctor ordered.
"Quite a lot of the general practitioners in the U.K. see it as a good way of doing a bit of triage," says Neal Patel, head of communications with Britain's National Pharmacy Association.
"There's the thought that this triage (takes care) of a lot of people ... leaving the GPs to get on with more serious illness and managing long-term conditions, that sort of thing."
Patel says the role of pharmacist as diagnostician and drug prescriber has been long established in Britain.
"The pharmacists in the U.K. have been dealing with these symptomatic ailments ... giving diagnoses (and) supplying medicines for many, many years," Patel says.
"So it's not an unusual part of their role. And the range of medicines is increasing all the time."
While part of their tradition, the practice has become more formalized and regulated in recent years, Patel says.
Indeed, in Scotland there is a national minor ailment scheme, Patel says, that allows patients to register with pharmacies so they can skip the doctor's office for numerous prescription-class medications.
A report by the provincial Health Professionals Regulatory Advisory Council, released by Queen's Park last week, recommends Ontario pharmacists be allowed to significantly expand the scope of their practices here.
One of the recommendations says the province should look at allowing pharmacists to prescribe medicines for certain – and as yet to be determined – minor ailments without a doctor's direct order.
That proposal has drawn the ire of the Ontario Medical Association, which advocates that doctors should have the exclusive right to diagnose diseases in the province.
Some of the simple maladies British pharmacists have come to prescribe medications for, include: chlamydia, pink eye, asthma, and some allergies and rashes.
Patel says the rules and protocols governing the types and severities of ailments British pharmacists can treat have come to be so strict and refined that they leave little room for overstepping or error.
The Ontario Pharmacists' Association, which is championing the changes here, is promising similar rules and protocols would be put in place.
The association says appropriate training would be mandatory for any pharmacist who wants to participate in a prescribing program.
Patel says pharmacists with the proper education and experience help make routine prescribing, such as ordering regular inhalers for asthmatics, more efficient.
But treatment boundaries, he says, have become rigid and well defined over the past decade and carry the blessing of doctors.
"Things like pink eye could be a more serious infection, so it's clearly set out that if people have it longer than a certain amount of time, or if they're in a particular age group, then they'll immediately be referred to a general practitioner."
Toronto Star