TORONTO — Fully implementing and funding expanded health care services approved last fall for Ontario pharmacists would significantly improve health outcomes, especially for seniors and patients with chronic diseases, according to Michael Holden, chief executive officer of the National Pharmacy Association in the United Kingdom.
Holden made his comments on Friday in a keynote address at the 2013 Ontario Pharmacists Association Conference in Toronto.
"Pharmacists in the U.K., as in other jurisdictions around the world, are remunerated for many more health care services than they are in Ontario," Holden told attendees. "In the U.K., it’s meant considerable health improvements, particularly among those who suffer from respiratory conditions, cardiovascular disease and diabetes.
"Regular interaction with pharmacists and their teams has led to healthier lifestyles, greater prevention and improved rates of avoidable mortality," he noted. "One support service for patients with respiratory conditions has led to a reduction in hospitalization by over 50%, by optimizing drug usage."
Health Services For Which Pharmacists
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Ontario |
United Kingdom** |
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Health promotion, disease prevention |
• Smoking cessation*
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• Healthy Living Pharmacy Initiative (addresses smoking cessation, obesity
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Medication therapy management |
• MedsCheck
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• Medication Use Review (MUR)
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Minor ailments |
Not yet authorized |
• Common/minor ailments program |
Chronic disease management |
MedsCheck Diabetes |
• Chronic Medication Service program
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* Limited to recipients under the Ontario Public Drug Program.
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Source: Ontario Pharmacists Association |
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In October, Ontario’s government approved regulations that allow pharmacists in the province to provide a wider range of pharmacy services. The new services include adapting and renewing existing prescriptions; prescribing certain drugs to help people quit smoking; administering (by injection or inhalation) specific substances to a patient for the purpose of education and demonstration; piercing the skin to support patient self-care and monitoring of a chronic disease (such as diabetes); and giving a flu shot to a person age 5 and older (as part of Ontario’s Universal Influenza Immunization Program). The flu shot component was initiated in late October.
The expansion of pharmacy services is part of Ontario’s Action Plan for Health Care, designed to provide improved access to affordable care from family doctors, nurse practitioners and other health care providers.
At the OPA conference, Holden said that since 2005, when the United Kingdom began expanding the range of services that pharmacies can provide and compensating pharmacies for those service, health outcomes have improved.
"It’s about converting the interaction with the pharmacist into an opportunity for an intervention related to the patient’s condition and, if it’s a factor, his or her lifestyle," he explained. "Ontario can seize the opportunity and do it."
OPA noted that Ontario’s government has a strong economic incentive for funding an expanded range of authority for pharmacists. A study by Accenture on behalf of OPA, released in March, found that the province could save its health system at least $143 million over the next five years by fully implementing and funding pharmacists’ authority in five key practice areas: assessing and treating minor ailments; counseling and prescribing for smoking cessation; administering flu vaccinations; adapting patient drug therapies; and renewing prescriptions for stable chronic conditions.
"Primary care trusts across the U.K. have implemented minor ailment programs that allow patients to be assessed and, if need be, treated for certain conditions directly by a pharmacist," stated Dennis Darby, CEO of OPA. "They’re seeing tremendous uptake by patients, increased capacity in the health system and improvements in access to primary care. The Accenture report found that similar results could be realized by implementing a minor ailments program in Ontario."
