How pharmacies are stepping in to fill the primary-care gap

With almost 40,000 people on New Brunswick's primary-care wait lists, the province and New Brunswickers are looking to pharmacies to help bridge the gap.

In recent months the province has been decreasing restrictions on what pharmacists can do for patients. Since October, pharmacists have been able to assess and prescribe medication for non-urgent urinary tract infections under Medicare.

This week, the province said it would allow pharmacists to renew prescriptions at no cost to the patient, whether they have a primary care provider or not, and without having to prove it's an emergency.

The changes are part of an effort to reduce strain on the health-care system as COVID-19 hospitalizations continue to increase.

They came hand-in-hand with Medicare-covered online doctor visits through eVisitNB, "treat and release" ambulance responses, and the 811 non-emergency medical care line.

Anastasia Shiamptanis, registrar for New Brunswick College of Pharmacists, said including pharmacists has brought to light how they can be a part of the primary-care solution.

"Patients should see them as part of their care ... Really seeing them as part of that team that's making sure that you're on the most appropriate therapy for your conditions," she said.

Prescription renewal

Shiamptanis said patients have been able to get a prescription renewal at a pharmacy for some time. However, now they no longer have to pay a $20 to $25 fee for that renewal, and people with a primary-care provider don't have to prove that it's an emergency.

Pharmacists can renew any medication as long as they believe there is no need for extensive testing and assessment for the medication to be renewed, she said.

There are also no limits on how long they can renew the prescription for, as long as the length of a renewal doesn't exceed the length of the original prescription. 

"It really depends on what the situation is," Shiamptanis said. "So you can leave the decision up to the pharmacist."

She said this will be an option for people who get anxious when it's time to renew because they don't have a primary-care provider or their provider isn't available.

One-stop-shop for 'minor ailments'

New Brunswick pharmacists have been able to assess and treat 32 minor ailments with no need for a doctor or nurse practitioner to be involved.

The list includes herpes simplex, or cold sores, fungal infections, nicotine dependency and urinary tract infections. Patients have had to pay a fee of $20 to $25 for treatment for all of the 32 conditions.

But recently, the province has begun covering "uncomplicated" urinary tract infections under Medicare in pharmacies, said Jake Reid, executive director of the New Brunswick Pharmacists' Association.

Reid said urinary tract infections are the primary reasons people ended up in an emergency room when they could have been treated at a pharmacy.

Reid said the association continues to call on the province to cover the cost of the remaining illnesses treated by pharmacists.

"If it's within their scope of practice ... then that should be something that's covered by Medicare."

Shiamptanis said pharmacists can also prescribe vaccinations needed for travel, as well as preventive vaccination such as the HPV cervical-cancer-prevention vaccine and the shingles vaccine.